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Background Falls are common in hospitalized patients undergoing autologous stem cell transplantation (ASCT). Research demonstrates that preventing patient falls requires knowledge of the risk factors and the circumstances preceding the patient's fall. . Objectives To identify risk factors related to falls in recipients of ASCT and assess the predictive value of the Morse Fall Scale (MFS). . Methods Of the 288 patients who underwent transplantation during the study period, 14 were fallers. Twenty controls were randomly selected. The study used descriptive case-control analysis and simple logistic regression to analyze the data. . Findings Eight fallers and four non-fallers had high MFS scores. The logistic regression model indicated that patients with high MFS scores were 5.3 times more likely to fall and that for each day patients experienced diarrhea, their risk of fall increased 1.2 times.

Introduction With an incidence of 5.6 per 100,000 per year, diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (Teras, 2016) and has a 5-year relative survival of 63.8% (SEER Statistics, 2018). While there is not currently a universally accepted timeline for initiation of therapy in DLBCL, retrospective studies have demonstrated that delays in initiation of treatment can lead to adverse outcomes in DLBCL, such as decreased overall survival (Phipps, 2018). We performed a retrospective review of Veterans Affairs (VA) patients nationwide to assess how frequently delays occurred in treatment initiation and we analyzed the impact of time to treatment on response rates to first-line chemotherapy and on survival outcomes. Methods We performed a retrospective chart review of 2036 randomly selected records of patients seen within the VA nationwide who were diagnosed with lymphoma between 1/1/2011 and 12/31/2017. We included patients diagnosed with DLBCL. We excluded other types of lymphoma, patients whose workup and treatment were outside of the VA system, and patients with primary central nervous system (CNS) lymphoma. We determined the time from diagnosis to treatment (TDT), defined as the number of days from the date of pathology results to the date of initiation of treatment for each patient, and divided these into two-week blocks. The Wilcoxon-Mann-Whitney test was used to compare median overall survival between the groups. Results 971 patients were included in the study. Patients were predominantly male (96.2%), with a median age of 67 (Table 1). The median TDT was 20 days. Those with TDT of 0-14 days, 15-28 days, 29-42 days, and 43+ days had an objective response rate (ORR) of 70.9%, 84.5%, 82.9%, and 77.6%, respectively (Table 2). The same groups had a 2-year overall survival (OS) rate of 61.6%, 77.6%, 80.7%, and 72.7%, respectively. They demonstrated median OS of 36.1 months, 46.9 months, 46.4 months, and 47.1 months, respectively. The 2-year OS rates were significantly lower for the 0-14 day group compared to the 15-28 days group (P = 0.0001), 29-42 group (P Although the rates of high International Prognostic Index (IPI) scores and advanced stage disease were highest in the 0-14 day groups, we found that when we assessed only the patients with IPI 3-5, the 2-year OS rates, ORR, and median OS trends were similar, with inferior outcomes in the earlier treatment initiation groups (Table 3). When we analyzed only the patients with stage III-IV disease, as well as only those who were outpatient at time of diagnosis, we again found similar trends of inferior outcomes in those who began treatment within 0-14 days. The Cox proportional hazards model was employed to explore factors associated with survival time (Figure 1). An increase in age, a higher IPI score, and being an inpatient at the time of diagnosis were statistically significant factors that explained a lower OS in the 0-14 day TDT subgroup. When these were included in the model, TDT no longer made a significant difference in OS. Conclusion Our study demonstrated that shorter TDT did not improve survival outcomes for this aggressive lymphoma, contrary to what we expected. In fact, patients who had shorter TDT had statistically significant lower survival rates at 2 years, lower median OS, and lower ORR. We theorized that there was a propensity for patients who have more high-risk disease to be started on treatment more quickly because they are more often symptomatic or gravely ill at presentation. We found that when we controlled for inpatient status, high IPI, and advanced stage disease individually, the survival outcomes remained poorest in the earliest treatment initiation groups. However, when we controlled for all of these variables, there was no longer a statistically significant difference in OS based on TDT. Future studies are needed to better understand why our outcomes differed from prior studies which showed improved survival and response in shorter TDT subgroups, and to control for other possible confounders, such as treatment regimens and patients' comorbid conditions. Disclosures No relevant conflicts of interest to declare.

Introduction Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL), constituting 25% of NHL cases (Teras, 2016). Although survival rates have improved, with a 5-year relative survival of 63.8% in the United States (SEER Cancer Statistics, 2018), outcomes in DLBCL remain heterogeneous with inferior survival amongst some patient subgroups. Racial and ethnic disparities in access to care and outcomes are well-established and are critical issues across a number of malignancies, including NHL (Shenoy, 2011; Griffiths, 2010). The purpose of this study was to assess for racial and ethnic differences in patient and disease characteristics at diagnosis, and in outcomes for patients diagnosed with DLBCL within the Veterans Health Administration (VHA), where access to care may be less susceptible to other socioeconomic factors. Methods Trained abstractors performed a retrospective chart review of 2036 randomly selected patients seen in the VHA nationwide who were diagnosed with lymphoma between 01/01/2011 and 12/31/2017. We included patients diagnosed with DLBCL and excluded patients based on the criteria in Figure 1. We evaluated baseline patient and disease characteristics, including Eastern Cooperative Oncology Group (ECOG) performance status, stage at diagnosis, International Prognostic Index (IPI) score, pathology reports to identify high-grade lymphomas, and response to first-line treatment. Results A total of 971 patients met inclusion criteria for analysis. Patients were predominantly male, white, had a median age of 67, and presented primarily with advanced disease (Table 1). Patients in each subgroup presented with similar rates of stage III and IV disease, with no statistically significant difference in stage at presentation amongst each racial subgroup (white vs black, P=0.85; white vs Hispanic, P=0.30; white vs other, P=0.11). Most patients in each racial/ethnic group had a good performance status at diagnosis, with ECOG 0-2 in 75.4 - 82.5% of patients in each subgroup. The entire study population had an objective response rate (ORR) of 87.4% (complete response (CR) rate 66%) (Table 2). Response rates were similar across the 4 subgroups, with the majority of patients achieving a complete response (CR) after first-line therapy (66.7%, 68.9%, 65.3%, and 70% for black, Hispanic, white, and other/unknown patients, respectively). There were no statistically significant differences in ORR amongst subgroups (white vs black, P=0.28; white vs Hispanic, P=0.75; white vs other, P=0.75). Median overall survival (OS) from the time of diagnosis was 40.5 months for the entire study population (Table 2). OS rates were similar regardless of race with a median OS of 43 months for black patients, 49.2 months for Hispanic patients, 40.5 months for white patients, and 33.3 months for other/unknown patients (Figure 2). There was no statistically significant difference in median OS between subgroups (white vs black, P= 0.84; white vs Hispanic, P=0.39; white vs other, P=0.18). The 1-year survival rates were similar at 75.8%, 72.1%, 76.4%, and 71.7% for black, Hispanic, white, and other/unknown patient subgroups, respectively. Between 60 - 68.5% of patients in each subgroup remained alive at 2 years, with no significant differences in survival rates at 1 or 2 years. Conclusions In this retrospective study of patients diagnosed with DLBCL in the VHA nationwide, we found that there were no statistically significant differences in baseline patient characteristics at diagnosis or in response rates to first-line chemotherapy, 1- and 2-year OS rates, or median OS amongst each racial subgroup. Potential limitations of this study include that the population is predominantly male and therefore, may not be applicable to the female population, and that there was missing/incomplete data for pathologic assessment of high grade lymphoma in 68.5% of our population, which could provide important data about expected outcomes. Further studies with a longer follow-up period are needed to help characterize potential differences in outcomes and relapse rates. Our data suggest that when standard of care therapy is given equally to patients with DLBCL, similar outcomes occur for black, Hispanic, and white patients. The development of interventions to address healthcare disparities and to ensure access to appropriate and timely care for all patient populations is of paramount importance. Disclosures No relevant conflicts of interest to declare.

Introduction: Diffuse large B-cell lymphoma (DLBCL), is predominantly diagnosed in the elderly with a median age of diagnosis approaching the seventh decade of life. The prognosis for DLBCL has improved for all age groups, but less so for those over 75 years of age. The VHA (Veterans Health Administration) is one of the largest integrated provider of cancer care in the United States and its population, on average, is older than the general US population, giving us an unique advantage in exploring outcomes in elderly population. Methods: We reviewed 2036 medical records on patients that had a diagnosis code of some form of lymphoma between 2011 to 2017. Patients were randomly selected. Inclusion criteria was any veteran with atleast one entry in their records of selected ICD-9 and ICD-10 codes for lymphoma. Exclusion criteria included primary CNS lymphoma, other low grade variant lymphomas, diagnosis and treatment outside VHA, inability to determine if patient record met study criteria or inability to fill in critical fields of interest for the study. 971 patients were included. Data was manually abstracted by trained researchers. The Wilcoxon-Mann-Whitney test was used to compare median Overall Survival (OS) between two groups. All statistical comparisons were made using the R statistical analysis package. A level of significance of 0.05 was used for all the tests. Results: Of the 971 patients that met the inclusion criteria, 739 (76.1%) were 3 (50.1 % in Patients in the For those who received chemotherapy, 82.4% in Conclusions: Nearly 1/4th of the patient population were older than 75 years, and despite receiving comparable lines of chemotherapy, had lower survival when compared to patients who were Disclosures No relevant conflicts of interest to declare.

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Sandia National Laboratories designs and builds Synthetic Aperture Radar (SAR) systems capable of forming high-quality exceptionally fine resolution real-time images. Resolutions as fine as 4 inches (10 cm) in both slant range and azimuth are routinely formed in real time on board Sandia’s DeHavilland DHC-6 Twin Otter aircraft using a Ku-band SAR. Resolutions as fine as 6 inches (15 cm) in both slant range and azimuth are routinely formed using an X-band SAR. Careful system design allows high image quality as measured by nearly ideal Impulse Response (IPR) shapes, with typical Multiplicative Noise Ratios (MNR) of better than 20 dB, and a noise equivalent reflectivity usually better than -30 dB. Collection geometries routinely include squint angles 45 degrees both fore and aft of broadside, on either side of the aircraft. This paper offers a collection of high quality images representative of the output of Sandia’s testbed radar. High-quality fine-resolution images of a variety of target scenes will be displayed, with annotation describing relevant image parameters. This paper is the second of a set of two portfolios.