Clinical Lymphoma, Myeloma & Leukemia, Vol.22, Suppl.2 - October 2022

Abstracts Clinical Lymphoma, Myeloma & Leukemia October 2022 S354 ABCL-038 HIV Status Affects Access to Autologous Stem Cell Transplant in Primary Central Nervous System B-Cell Lymphomas in a Minority Rich, Ethnically Diverse and Socioeconomically Disadvantaged Population at Montefiore Medical Center/Albert Einstein College of Medicine Hiba Narvel MBBS 1 , Charan Vegivinti MBBS 1 , Daniel Reef MD, BA 2 , Sindhu Vikash MD 1 , Shuai Wang MD 1 , Abdul-Hamid Bazarbachi MD 1 , Adnan Narvel MBBS 3 , Alyssa De Castro PharmD 2 , Jennat Mustafa PA-C 2 , Fariha Khatun PA- C 2 , Amanda Lombardo PA-C, BS, MS 2 , Latoya Townsend Nugent NP 2 , Kira Gritsman MD, PhD 2 , Mendel Goldfinger MD 2 , Noah Kornblum MD 2 , Aditi Shastri MD 2 , Ioannis Mantzaris MD 2 , Amit Verma MD 2 , Ira Braunschweig MD 2 , Alejandro Sica MD 2 1 Jacobi Medical Center, Albert Einstein College of Medicine, New York, USA. 2 Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA. 3 Pravara Institute of Medical Sciences, Ahmednagar, India Co n text: Primary CNS lymphoma (PCNSL) is a rare, aggressive neoplasm showing frequent relapses. Though autologous stem cell transplant (ASCT) has shown survival benefits, data regarding access to and outcomes of ASCT in racial minorities and socioeconomically disadvantaged groups is limited. Objecti v es: To identify variables, such as race/ethnicity, socioeconomic status (SES), and HIV status, associated with access to ASCT and outcomes in patients with PCNSL. D esig n : Retrospective cohort including patients from 06/01/2000 to 04/05/2022. Setti n g: Tertiary oncologic center. Patie n ts: Fifty-three PCNSL patients with a median age at diagnosis of 63 years were included. The cohort was 7 % Asian, 29% Black, 2 7 % Hispanic, 1 7 % White, and 20% other. Eighteen percent of the patients were HIV positive, thrice the global prevalence of HIV in PCNSL patients. Methods: Electronic health records were reviewed. SES was measured using the area deprivation index (ADI), composed of 1 7 categories and validated for a range of health outcomes and disease domains (Kind et al. NEJM 2018). Mai n Outco m e Measures: Correlation of different demographic variables with access to ASCT and overall survival (OS). Results: The most common induction chemotherapy and conditioning regimens were remdesivir and TBC (thiotepa, busulfan, and cyclophosphamide), respectively. Our population had a higher poverty index than the national average (median NY state ADI: 5th percentile). Thirty-two percent of the patients in our cohort received ASCT (1 7 /53), better than the national average of 12.9% in PCNSL patients in 2020. In a logistic regression model, HIV-positive status was significantly associated with decreased access to ASCT ( P =0.01). ADI and race/ ethnicity did not affect access to ASCT. One-year OS was 80%, and no significant difference was found between those treated with ASCT and those who were not. Median OS was not reached in ASCT recipients. When adjusted for the other variables, Karnofsky scores >90 at diagnosis were associated with increased access to ASCT ( P =0.04). Co n clusio n s: In our population, HIV positivity limited access to ASCT, but race/ethnicity did not. Neighborhood disadvantage (ADI) also did not affect access to ASCT as patients were within a narrow range of extremely low socioeconomic status. Analyzing larger datasets of HIV-positive individuals with PCNSL can provide further insights into factors affecting ASCT access and outcomes. Keywords: ABCL, primary central nervous system lymphomas, access to hematopoietic stem cell transplant, racial inequities, socioeconomic inequities. ABCL-043 Prognostic Factors for High-Grade B Cell Lymphoma Patients Treated With Commercial CD19-Targeted CAR T-Cell Therapy Hazim S. Ababneh MD, Matthew J. Frigault MD, Chirayu G. Patel MD, MPH Massachusetts General Hospital, Boston, USA Co n text: We hypothesized that specific clinicopathologic characteristics are correlated with survival outcomes among high- grade B cell lymphomas (HGBCL) patients treated with CD19- targeted chimeric antigen receptor (CAR) T-cell therapy. Objecti v es: To identify the prognostic factors for survival outcomes among patients with relapsed/refractory HGBCL undergoing CAR T-cell therapy. Materials/Methods: A retrospective study was conducted for consecutive HGBCL patients who received either tisagenlecleucel (tisa-cel) or axicabtagene ciloleucel (axi-cel) CAR T-cell therapy between 201 7 and 2021 at a single institution. Post-CAR T best overall response was defined as the lowest disease burden measured at any time between post-CAR T-cell therapy and additional salvage therapies. Results: A total of 101 HGBCL patients were identified with a median follow-up of 8.3 months (range, 0.13-49.5 months) from the date of CAR T infusion. The median OS and PFS for the entire cohort were 15 months (95%CI: 8.6 months-not reached) and 4.4 months (95% CI: 3.03 months- 7 .23 months), respectively. The best overall response (complete response-CR and partial response) and CR rates post-CAR T were 7 5% (n= 7 1) and 48% (n=46), respectively. In univariate analysis, absence of CNS involvement (OR=6.8, p=0.001), IPI score <3 at the time of apheresis (OR=3.4, p=0.003), limited-stage disease at the time of apheresis (OR=3.2, p=0.005), low LDH level at the time of apheresis (OR=5.4, p<0.001), undergoing HSCT pre-CAR T (OR=3.1, p=0.01), and not receiving salvage radiotherapy pre-CAR T (OR=4.2, p=0.03) were predictive of achieving CR post-CAR T. Sixteen patients (22%) had bulky disease (  5 cm) as per PET/CT post-CAR T, 81% (n=13) of which were bulky pre-CAR T-bulky data was missing for 4 patients. In multivariate analysis, presence of bulky disease (  5 cm) post-CAR T infusion was a significant prognostic factor for worse OS (HR=6.3, 95% CI: 2.9-13.6, p<0.001). Regarding PFS, high LDH at the time of apheresis, age (  60) at the time of apheresis, and bulky disease (  5 cm) post-CAR T infusion were significant prognostic factors for inferior PFS (HR=1.9, 95% CI: 1.02-3.8, p=0.04, HR=2.6,