The first prospective study of intensive therapy for FL in Russia has demonstrated that HDCT with further auto-BSCT in first-line therapy allows complete remission in patients with poor prognostic factors and higher overall and progression-free survival rates.

Background: FL is one of the most frequent types of lymphomas: it consists about 22% of non-Hodgkin lymphomas in Russia. 20 % of pts have an aggressive tumor after standard therapy. In FL pts with unfavorable prognosis (FLIPI-1 III-IV, fast growth of tumor mass, B-symptoms, third cytological grade of tumor, bulky, absence of tumor response after first line R-CHOP-21 therapy) autoSCT allows to increase the overall (OS) and progression-free survival (PFS). Aim: To estimate an efficacy of HDT (high dose therapy) with following autoSCT in front-line therapy of FL pts with factors of poor prognosis. Patients and Methods: Since 2000 to 2015 years in National Research Center for Hematology were treated 39 FL pts with poor prognosis. All pts received R-CHOP-21 induction therapy. In 24 patients (62%) who hadn't partial response or poor prognosis patients with partial response after 4-6 courses autoSCT was performed. This group consists of 17 males and 7 females with median age 46 years old (31-68). Majority of pts (23/24) had IV stage of disease according to Ann Arbor. In 16/24 (66%) cases pts had bulky disease. 3/24 pts had phenomenon of leukaemization. Basing on FLIPI-1 criteria all pts were divided into 3 groups: low risk - 5/24, intermediate - 3/24, high - 16/24. B-symptoms were in majority of cases (18/24). 18/24 pts were diagnosed with I-II cytological grade of FL, 6/24 - III A/B. Basing on tumor growth pattern there was following ratio: nodular tumor growth revealed in 6/24 pts, nodular-diffuse tumor growth - in 15/24, diffuse tumor growth - in 3/24. Immunochemical analysis of serum and urine proteins was performed in 20/24 cases, among them increased level of serum β2-microglobulin was diagnosed in 10/20 pts. Increased activity of lactate dehydrogenase (LDH) was revealed in 16/24 pts. Bone marrow involvement at the time of disease onset was diagnosed in 18/24 pts. Results: After induction R-CHOP-21 chemotherapy pts underwent HDT which included two courses R-DHAP, following high-dose cyclophosphamide with rituximab, then high dose etoposide with rituximab. As condition regimen R-BEAM was performed. All 24 FL pts, who underwent autoSCT, continue to be in complete remission. Median follow-up was 31 months (7-178). Conclusions: Preliminary results of the first prospective study of intensive therapy of FL in Russia demonstrate that autoSCT in front line therapy provides to achieve a complete remission in pts with poor prognosis and allows to increase an overall and disease-free survival. Disclosures No relevant conflicts of interest to declare.

Background: Mantle cell lymphoma (MCL) is a B cell malignancy accounting for 3-10% of all Non-Hodgkin Lymphomas and arises mainly in older adults with a male predominance (McKey et al). Historically, median survival was 4-5 years (Herrmann et al, 2009) however this is now in the order of 8-12 years in younger fitter patients who are able to tolerate intensive therapies (Eskelund et al, 2016). The current standard treatment is chemoimmunotherapy with or without autologous stem cell transplantation (ASCT). Although intensive therapy can achieve durable responses most patients eventually succumb to their disease. Novel therapeutic agents have shown efficacy in relapsed/refractory disease and are now being tested as frontline treatment (Sharma et al, 2018). Aims: We report a single centre experience of MCL and its treatment. Methods: Retrospective data was collected on all patients diagnosed with MCL at Ipswich Hospital NHS Trust over a nine year period between January 2010 and January 2019. Results: Forty-two patients were included in the analysis. Median age was 68yrs with a male to female ratio of 5:1. Eastern Co-operative Oncology Group (ECOG) performance status ranged from 0-1 in 66%, ≥2 in 14% and 19% had no status documented. Twenty-four patients (57%) received a non-intensive chemoimmunotherapy regimen; rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or rituximab-bendamustine (BR) as first line treatment with twenty of these patients receiving rituximab maintenance. Thirteen patients (31%) were fit enough to receive an intensive chemoimmunotherapy regimen with all but one consolidated with an ASCT. Of those transplanted five went on to receive rituximab maintenance. The remaining 12% of patients received either R-Chlorambucil, palliative radiotherapy, FCR or supportive care. The median Kaplan-Meier overall survival (OS) for all patients had not been reached. Median progression free survival (PFS) was 48 months. Comparing first line therapies, the median OS for those that received RCHOP/BR was 60 months with a median PFS of 35 months vs. not reached for both OS and PFS with intensive chemoimmunotherapy followed by ASCT. Eighteen patients had relapsed during the nine year period. There was no standard second line treatment. Eight patients received further chemoimmunotherapy including BR, R-cytarabine and FCR, one PEP-C, three ibrutinib, four palliative radiotherapy and two received supportive care only. After first relapse median PFS was 6 months and median OS was only 10 months. Nine patients received a third line treatment, of which 3 received ibrutinib and one venetoclax and the median OS was 9 months. The six relapsed/refractory patients that received Ibrutinib at either first or second relapse had a median OS of 8 months vs. 12 months in those that received other forms of therapy. Summary/Conclusion: As expected the best outcomes were with high intensity regimens consolidated by ASCT. Our data period was not long enough to show the continuous pattern of relapse despite durab...

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