Search

e17568 Background: Race and payer status have been shown to impact the outcome of several hematological malignancies including multiple myeloma and acute leukemia. There is, however, limited inform...

e16103 Background: Radium-223 dichloride (Ra-223), which selectively targets osteoblastic metastases with alpha particles, has been approved for treatment of castration-resistant prostate cancer (C...

Abstract 4894 Nodular Lymphocyte Predominant Hodgkin's Lymphoma (NLPHL) is an uncommon subtype of Hodgkin's lymphoma. NLPHL represents a more indolent disease than classical Hodgkin's lymphoma. It has unique clinicopathological features that resemble indolent Non Hodgkin's Lymphomas and hence, the tendency to manage it as such. We reviewed the activity of Rituximab-Bendamustine (RB) combination in 2 cases of relapsed NLPHL. The first patient is a 53 year old African American man who was diagnosed with Ann-Arbor Stage IIA NLPHL in 2005. He was initially treated with 3 cycles of ABVD after which he was lost to follow up. He sought medical attention in 2008 and a repeat PET/CT showed persistent cervical lymphadenopathy consistent with his known disease but the patient refused therapy at that time. Three years later, he presented with weight loss and enlarging cervical lymph nodes. A repeat biopsy of these nodes confirmed his initial diagnosis of NLPHL. He was reluctant to undergo any chemotherapy similar to the initial treatment because of the side effects. He was then treated with 4 cycles of RB followed by involved field radiation therapy, which he tolerated well. Post therapy PET/CT scan revealed a complete remission. The second patient is a 62 year old white man who was initially diagnosed with IE DLBCL of the proximal jejunum in 2004 which was successfully treated with R-CHOP. After five years he was found to have diffuse lymphadenopathy. Excisional biopsy revealed NLPHL. The patient refused to take adriamycin containing regimen or combination therapy since he poorly tolerated it before and agreed to try RB instead. He was treated with 6 cycles of RB. Re-staging PET/CT scans revealed near complete resolution. The patient was referred for autologous stem cell consolidation. He underwent adequate stem cell collection and successfully engrafted. Both patients continue to be disease free as of their last clinic visit. Rituximab –Bendamustine combination seems to have significant activity in NLPHL, reminiscent of its activity in indolent non-Hodgkin's lymphomas. Incorporation of the regimen into front line treatment of patients with this disease needs further study and evaluation. Disclosures: Off Label Use: Rituximab and Bendamustine are not FDA approved for NLPHL. Haddad:Cephalon: Honoraria, Speakers Bureau.

Abstract 3821 Introduction: The impact of socioeconomic status on patients with cancer has been previously reported. Health care funding improves access to care and thus outcome. There is little information on the impact of health care funding on hematological malignancies including multiple myeloma. Objectives: To analyze the effect of health care funding on the survival of patients with multiple myeloma (MM) and monoclonal gammopathy of uncertain significance (MGUS) in North Louisiana. A retrospective study of all patients diagnosed with multiple myeloma/MGUS and treated at Louisiana State University Health Science Center in Shreveport, LA between the years 1997 and 2010 was completed. Methods: Electronic medical records from our hospital and Social Security Death Index were used to identify patients and to define patient characteristics, demographic factors, medical funding source and date of death. Medical funding was defined as being funded (Medicaid, Medicare or private insurance) or non-funded (free care or self pay). Descriptive statistics, Product-Limit methods were used to estimate survival and Log rank test was used to compare the survival difference for each factor. Result: 257 patients were reviewed, of which 208 had multiple myeloma and 49 had MGUS. Median age of patients with MGUS and MM was 59 years and 60 years respectively (range 30–93).There were 92 (37%) Caucasians and 165 (63%) African Americans, 114 (44%) male and 143 (56%) female patients, and 177 (69%) were funded and 80 (31%) were non-funded. Of the patients with MM, 49 (23.5%) were stage 1, 23 (11%) were stage 2, 95 (45.6%) were stage 3A and 41 (19.7%) were stage 3B disease. The 5-year survival for MM was 60% and 42% for funded and non-funded patients respectively (p=0.03). The 5-year survival for MGUS was 95% and 62% for funded and non-funded patients respectively (p=0.012). Funded patients with MM had an overall survival of 6.2 years while it was 3.8 years for the non-funded (p=0.012). The survival difference relative to race and sex was not statistically significant. Conclusion: Our analysis demonstrates that patients with multiple myeloma and MGUS with funding have statistically significant increased overall survival compared to patients with no funding. Presumably patients with funding have better access to medical care, which would allow for earlier diagnosis, more effective therapy of smaller tumor burden and access to all therapeutic options. Lead time bias could contribute to some of the improved survival but is doubtful. To our knowledge, this is the first study to explore the impact of health funding on the survival of patients with multiple myeloma and MGUS, however validation with a larger prospective study is needed. Disclosures: No relevant conflicts of interest to declare.

Background Patients with human papillomavirus (HPV) infection are at risk of developing cancer later in their life. Current research estimates the prevalence of genital HPV infection and explores the factors that are associated with the infection. Findings The National Health and Nutrition Examination Survey 2007–2010 was used in this research study. The study population included females in the United States aged 18–59 years. The weighted prevalence of HPV infection was 41.9%. An estimated 59.4% of non-Hispanic black females had HPV infection. In a multivariate analysis, number of sexual partners, race, age, education level, marital status, income, smoking, and insurance status were associated with HPV infection. HPV infection was 5.77 times more likely for women with >11 sexual partners compared to women with 0–1 partners. Non-Hispanic black females were 1.87 times more likely to have HPV infection compared to non-Hispanic white females. Participants with only a high school degree had a 58% increased prevalence compared to college-educated women. Uninsured women had a 39% increased prevalence compared to those with insurance. Conclusion This study found that 41.9% of U.S. females aged 18–59 years tested positive for genital HPV infection. We determined that individuals with more sexual partners, with a lower education level, with non-Hispanic black race, and with no insurance were the populations at greatest risk. It is necessary to continue monitoring the prevalence of this infection in the general population to provide a basis for effective treatment and prevention in the target populations.