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Background Allogeneic stem cell transplantation (allo-SCT) using an HLA-matched sibling donor remains the only curative treatment for young patients with acquired severe aplastic anemia (SAA) [1]. When a matched sibling is not available and a patient does not achieve a response to immunosuppressive therapy (IST), allo-SCT from an unrelated donor (URD-SCT) is the preferred alternative. However, haplo-SCTs are increasing as a graft from a related mismatched donor is readily available for most patients and has the advantage of allowing for prompt transplantation. Therefore, haplo-SCT is a front-line therapy option for very SAA (VSAA) when the patient is not able to receive a SCT from emergent compatible donors. Methods We collected clinical data on 38 consecutive patients with aplastic anemia (AA) all of whom were treated at the Lu Daopei Hospital between December 2013 and July 2020. Patients had a median age of 8 (range: 1-34 years), 21 patients were male and 17 were female. Of the enrolled patients, 4 had 4 congenital AA, 34 had acquired AA and 3 had hepatitis-associated SAA. Median time from diagnosis to transplant was 9 months (range: 1-282 months). Eleven (28.9%) patients failed to receive ATG/ALG treatment. Twenty-six patients received a haploid-SCT, three patients received a sibling HLA-matched SCT and 9 patients received a URD-SCT. The sources of donor stem cell were parents in 11 cases, brothers and sisters in 6 cases, and unrelated donors in 9 cases. Median age of the donors was 32 (range: 11-57 years). Moreover, there was 13 donors that were incompatible in blood type with the patients. With regard to HLA matching type, 16 patients were HLA 5/10 and 22 patients were ≥ HLA 6/10. The stem cells were derived from BM+PBSC in 29 cases and from PBSC in 9 cases. The median dosage of MNC transfusion was 12.385x108/kg (range: 4.97-29.44x108/kg), CD34+ cell transfusion was 9.42x106/kg (range: 2.64-22.4 x106/kg) and CD3+ cell transfusion was 2.26 x106/kg (range: 1.11-7.92 x106/kg). Preparative regimen were Flu/Cy/ATG+TBI 200cGy for 30 patients, Bu for eight of the patients and three patients received BU+TBI. Additionally, all patients were treated with CSA/FK506 + MMF + sMTX to prevent GVHD. Results The median follow-up was 26.5 months (range: 1-103 months). All 36 cases were engrafted and no primary graft failure occurred. There was only one case of secondary graft failure. The median day of leukocyte engraftment was day +13 (range: +10 to +23), the median day of platelet engraftment was day +10.5 (range: 6-167). An Evaluation of bone marrow at one month after transplantation showed all patients were fully donor type. The overall survival (OS) rate was 92.1%, OS for haplo-SCT was 88.5%, and OS for HLA-identical SCT (sibling HLA-matched SCT + URD-SCT) was 100% (Figure 1). Conclusions In conclusion, the outcomes of haplo-SCT with TBI 200 cGy/Flu/Cy/ATG indicate that haplo-SCT can be an effective alternative option for SAA patients when fully matched or unrelated matched donors are not available, or for patients with VSAA who need an urgent transplant. Figure Disclosures No relevant conflicts of interest to declare.

18 Background: Cancer self-management involves active partnership between patients and their informal caregivers (ICs). There is a dearth of literature on ICs to lung cancer patients. Multi-modality treatment and profound challenges in symptom management and lifestyle adjustment are hallmarks of this population. This study aimed to describe the characteristics of, and resources utilized by ICs to lung cancer patients and examine the association between symptom severity and a) caregiver burden and b) perceived support. Methods: This study was conducted at a cancer centre north of Toronto, Canada. Dyads of lung cancer patients receiving outpatient treatment and their self-identified ICs (N = 39) were recruited. Upon consent, participants completed a one-time survey which assessed study variables employing previously validated instruments, including: patient’s functional status, caregiver burden, caregiver’s perceived social support and utilization of resources to enhance self-management. Descriptive analysis was used to describe our sample and frequency of resource utilization. Pearson’s correlation was used to examine the association between symptom severity and a) caregiver burden and b) perceived support. Results: The study sample consisted of middle-aged patients and caregivers (median 55-64 years). A majority of caregivers were female (76.2%), received education above college level (56.1%) and were immediate family members (80.9%). The most frequently utilized resources were the lung cancer patient handbook (48.8%), followed by personal support worker (29.3%). Caregiver support group was the least utilized (10%) resource. Patient’s symptom severity was negatively correlated with one aspect of caregiver burden, caregiver’s self-esteem (r = -0.36, p < 0.05). Conclusions: Findings indicated similarities in caregiver demographics to carers of other patient populations. Informational support and material aid appeared to be the most important resources. Patients’ well-being had the greatest impact on caregivers’ self-esteem, indicating implications on person-centred care and collaborative patient-provider relationships to support patient self-management.

Objective To detect the effect of bleeding on hospitalised acute myocardial infarction (AMI) mortality in patients aged 80 and over. Methods Life-threatening bleeding and major or minor bleeding is defined according to TIMI criteria. In a cohort of AMI patients aged ≥80 years from 2003 to 2012 at CCU department in fuxing hospital, the bleeding condition and the effect of bleeding on mortality was evaluated. Results 386 patients presenting with ST segment elevation AMI (STEMI) and non-STEMI were enrolled. A total of 90 patients died among hospital, and bleeding was observed in 45 cases, including 13.3% of TIMI life-threatening bleeding, 15.6% of TIMI major and 71.1% of minor bleeding. 111 cases of bleeding were observed in the survivors, including 11.7% of major bleeding and 88.3% of minor bleeding. The TIMI life-threatening bleeding and major bleeding There was significant difference in bleeding between the two groups, X 2 = 16.303, P Conclusions Patients aged 80 and over have high bleeding during hospitalisation, major and life-threatening bleeding was an independent significant predictor associated with hospitalised mortality.

Objective To investigate the gender difference of bleeding in acute myocardial infarction patients aged 80 and over. Methods Life-threatening bleeding and major or minor bleeding is defined according to TIMI criteria. In a cohort of AMI patients aged ≥ 80 years from 2003 to 2012 at CCU department in fuxing hospital, the bleeding condition and the gender difference of bleeding was evaluated. Results 386 patients presenting with ST segment elevation AMI (STEMI) and non-STEMI were enrolled, which included 189 male and 197 female. Bleeding was observed in 37.6% of male and in 43.1% of female, Pearson chi-square showed that there was no gender difference in bleeding during hospitalisation, X 2 = 1.248, P = 0.264. In the male patients, 2.8% of TIMI life-threatening bleeding, 19.7% of major and 77.5% of minor bleeding were discovered. 4.7% of TIMI life-threatening bleeding, 7.1% of major bleeding and 88.2% of minor bleeding were observed in the female patients. There was no significant gender difference in TIMI bleeding, X 2 = 5.802, P = 0.057. Conclusions Our study demonstrates that no significant gender difference in TIMI bleeding in oldest-old patients with AMI is discovered.

Objective To detect the value of B-type natriuretic peptide (BNP), white blood count (WBC), Creatinine, TNT and CK-MB in predicting acute myocardial infarction (AMI) mortality in patients aged 80 and over. Methods Mortality is defined as all-cause death rate during hospitalisation. The discrimination ( c statistic) was evaluated. Results 384 patients presenting with ST segment elevation AMI (STEMI) and non-STEMI were enrolled. The mortality was 23.4%. The overall discriminatory capacity of BNP, WBC, Creatinine, TNT and CK-MB was 0.755 (95%CI: 0.7–0.811), 0.658 (95%CI: 0.593–0.723), 0.647 (95%CI: 0.578–0.716), 0.626 (95%CI: 0.562–0.690) and 0.619 (95%CI: 0.558–0.679), respectively. The discriminatory capacity of the BNP was good. Conclusions BNP is a useful risk predictor for hospital mortality of AMI patients aged 80 and over.

Objective To explore the risk predictors of AMI mortality among hospital in patients aged 80 and over. Methods In a cohort of AMI patients aged ≥80 years from 2003 to 2012 at CCU department in fuxing hospital, we explored the determinants to predict death risk among hospital. Variables examined included demographics, history, hemodynamic condition and laboratory results. Results 386 patients presenting with AMI were enrolled. The hospital mortality rate was 23.3%. Multivariable stepwise regression analysis showed that eight independent significant predictors associated with mortality among hospital were history of stoke, cardiac shock, killip class III to IV, ventricular tachycardia, pulse rate ≥100 bpm and EF≤40% at presentation, in hospital bleeding, initial serum creatinine concentration ≥ 177umol/l and elevated initial WBC level. Hosmer-Lemeshow p value is 0.076 (chi-square: 12.871), which indicates good-fitness of the predict variables. Conclusions Patients aged 80 and over have high mortality during hospitalisation, these risk prediction factors are clinically useful for predicting mortality in patients with AMI.