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

Abstracts Clinical Lymphoma, Myeloma & Leukemia October 2022 S400 patients, results are encouraging with allo-SCT. Keywords: TCL, PTCL, relapsed, refractory, transplant, outcome TCL-360 A Case of Angioimmunoblastic T-Cell Lymphoma Presenting as Airway Obstruction Akshat Saxena MBBS 1 , Tanya Amal MBBS 2 , Ratesh Khillan MD 3 1 VMMC, New Delhi, India. 2 MAMC, New Delhi, India. 3 SUNY Downstate, New York City, USA Angioimmunoblastic T-cell lymphoma (AITL) is a rare subset of non-Hodgkin lymphoma (NHL). The incidence in the United States is 0.05 per 100,000 person years. It comprises 15%–20% of the cases of peripheral T-cell lymphoma. The most common presentation is generalized lymphadenopathy. NHL is known to involve Waldeyer’s ring as the primary site of disease in 5% to 10% of cases. An 83-year-old woman presented to the outpatient clinic with shortness of breath, noisy breathing, and right groin swelling. Physical examination revealed diffuse lymphadenopathy. A complete blood count revealed moderate anemia, normal white blood cell count, and thrombocytosis. A liver function test revealed increased alkaline phosphatase (ALP) and alanine transaminase (ALT) levels. Serum albumin and haptoglobin were low. A CT scan of the chest revealed mediastinal and axillary adenopathy. Brain CT showed a nasopharyngeal mass 2×2 cm. Multiple hypodense lesions were seen in the liver. A biopsy of the right inguinal mass revealed an angioimmunoblastic variant of T-cell lymphoma. The patient was started on a MiniCHOP with prednisone regimen. AITL is a rare disease of older adults. Our patient presented with asymmetrical right inguinal lymphadenopathy. Waldeyer’s ring involvement is rare in NHL and is large enough to cause symptomatic breathing difficulty. The nasopharyngeal mass possibly contributed to the noisy breathing. The patient’s lab results revealed thrombocytosis and a normal leukocyte count, which were a deviation from the cytopenias seen in AITL. The patient had an increase in ALP and ALT levels. In the absence of history of alcohol intake, diabetes mellitus, and obesity, these findings are suggestive of metastatic liver involvement. Due to its low incidence, there is a dearth of large-scale studies evaluating the presenting symptoms of AITL. The variations in laboratory abnormalities from routine findings also warrant further studies. The predominant involvement of nasopharyngeal mucosa leading to breathing difficulties in this case highlights the importance of having high suspicion, since AITL can present as various unique clinical scenarios. Keywords: TCL, angioimmunoblastic T-cell lymphoma, Waldeyer’s ring, airway obstruction, non-Hodgkin lymphoma, MiniCHOP regimen, case TCL-456 Real-World Use of Mogamulizumab among Patients With Mycosis Fungoides and Sézary Syndrome Before and During COVID-19 in the United States Yang Zhao PhD 1 , Jackson Tang MSc 1 , Huanxue Zhou MS 2 , Takeshi Takahashi PhD 3 , Takanobu Nomura PhD 3 , Eslie Dennis MD, MBChB, FCP(SA) 1 , Ahmad Halwani MD 4 1 Kyowa Kirin, Inc., Bedminster, USA. 2 KMK Consulting, Morristown, USA. 3 Kyowa Kirin Co. Ltd., Tokyo, Japan. 4 University of Utah Huntsman Cancer Institute, Salt Lake City, USA Backgrou n d: Per label, mogamulizumab (Moga) is administered on days 1, 8, 15, and 22 of the first 28-day cycle (loading) and on days 1 and 15 of each subsequent cycle (maintenance) for adult patients with relapsed or refractory mycosis fungoides (MF) or Sézary syndrome (SS) after  1 prior systemic therapy. During the COVID-19 pandemic, professional organizations suggested dosing intervals for systemic cancer therapies be extended to limit in-person visits. This study examined the real-world use of Moga before and during the COVID-19 pandemic in the United States. Methods: Using the Symphony Health Solutions database, adults with  1 diagnosis of MF or SS (ICD-10 CM: C84.0x or C84.1x) and  1 Moga claim during 10/1/2018-5/6/2021 were identified. Within the MF (no SS diagnosis) and SS (any SS diagnosis) cohorts, patients were divided into 2 subgroups based on their Moga initiation date: 10/1/2018-3/31/2020 (pre COVID-19) and 4/1/2020-5/6/2021 (COVID-19). Patient characteristics and dosing intervals between Moga doses 1-4 (loading) and between subsequent doses (maintenance) were examined. Results: Overall, 154 MF and 204 SS patients initiated Moga during the study period (mean age: 66.8 and 69.2 years; male: 64% and 55%, respectively). In the MF cohort, 98 and 56 patients were in the pre COVID-19 and COVID-19 subgroups. The mean dosing interval was shorter among patients in the COVID-19 subgroup for both the loading (9.1 vs. 13.2 days) and maintenance doses (15.2 vs. 16.1 days). In the SS cohort, 121 and 83 patients were in the pre COVID-19 and COVID-19 subgroups. Mean loading (9.0 vs. 11.1 days) and maintenance (15.0 vs. 16.8 days) dosing intervals were shorter for patients included in the COVID-19 subgroup. For both MF and SS patients, the COVID-19 subgroup had a higher proportion of patients with  10 days between loading doses and  21 days between maintenance doses compared to the pre COVID-19 subgroup. Co n clusio n s: Among MF and SS patients, dosing intervals for Moga in loading and maintenance were not extended during the 1st year of the COVID-19 pandemic compared to pre COVID-19. There was a trend towards closer concordance with the label during COVID-19. Keywords: TCL, mogamulizumab, real-world, T-cell lymphoma