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Introduction: The incidence of bone marrow involvement (BMI) in patients diagnosed with Hodgkin Lymphoma (HL) is relatively low varying from 4-14% in different series occurring mainly in patients with advanced disease (stage III-IV). Ann Arbor staging system with Cotswolds modification in 1989 recommend staging bone marrow in patients with clinical stage III-IV and stage II patients with adverse risk features. It’s utility is now questionable and no longer recommended by many authors as it does not alter the way patients are managed. The advent of 18F-fluoro-2 –deoxy-D-glucose positive emission tomography (FDG-PET) scan use in the staging of patients has improved the prediction of possible bone marrow involvement obviating further the need for bone marrow biopsy. While BMI is said to be an independent prognostic factor in the survival of patient with HL, more studies have shown that BMI alone in patients with Stage IV disease does not influence survival or freedom from disease progression. Because staging bone marrow biopsy (BMB) use in HL varies from one institution to another, we performed a retrospective review in our institution in order to determine its incidence, risk factors and effect in the management of patients. Methods: We performed a retrospective search in John H Stroger, Jr. Hospital database of patients with HL seen from 2004 to 2013. 237 adult (18yr and above) patients were screened. 185 patients had BMB done as part of work up. Results: BMI was detected in 21%(38 of 185) of patients who had BMB as part of work up. M:F ratio was 2.5:1. Mean age was 39.8 +/- 11.5yrs. 51%(95 of 185) of patients who had BMB had advanced disease. 94%(33 out of 35) of patients with BMI had advanced disease prior to BMB. 3 patients with BMI were incompletely staged. Advanced disease was significantly more likely to be associated with BMI than early stage disease (OR 20.2 95% CI 4.6-87.6 p=0.0001). Less than 1%(2 out of 78) of patients with early stage disease were upstaged .The 2 patients that were upstaged had Stage IIB disease prior to BMB.38%(14 of 37) of patients with BMI were HIV positive which was higher compared to 12%(16 of 129) of patients without BMI that were HIV positive (OR 5.8 95% CI 2.4-14.0 p=0.0001). 5 of 38 patients with BMI had staging FDG-PET and all showed positivity in the skeletal system. Patients with BMI in our review were managed with 6-8cycles of chemotherapy (CT)-Adriamycin, Bleomycin, Vinblastine and Dacarbazine regimen (ABVD). 5 cases were relapsed disease. 4 of these patients with relapsed disease received Platinum/Gemcitabine regimen and one patient received Mechlorethamine, Vincristine, Procarbazine and Prednisone regimen (MOPP). Radiation Therapy (RT) was part of the management in 4 patients done for cord compression (2), bulky mediastinal disease (1) and for residual disease after chemotherapy (1). Conclusions: The incidence of BMI was high in our retrospective review compared to other series, however majority of involvement were in patients with advanced disease as in most series. Patients were rarely upstaged from early stage to advanced stage with bone marrow biopsy. This occurred in less than 1% in our retrospective review. Staging FDG-PET although done in few of our patients with BMI was predictive. Management of these patients was not significantly altered based on BMI. They were managed mainly with CT. RT needed in some of these patients was justified (cord compression, and bulky mediastinal disease). RT for residual disease is not a standard of care. Risks factors identified for BMI includes advanced disease and associated HIV infection. BMB does not alter patient management and its sole prognostic significance in patients with stage IV disease is controversial. It is therefore not necessary in the staging of newly diagnosed patients with HL. Disclosures No relevant conflicts of interest to declare.

e18534 Background: MALToma represents about 5% of Non-Hodgkin lymphomas (NHL). Prior studies report stomach to be the most common site of involvement (35-50%), while skin (16%) or salivary glands (26%) were reported to be the 2nd most frequent site in 2 different studies. Geographical variation may affect the proportions of primary sites of MALToma, which could provide further clues to investigating their causes. Methods: The data was obtained on 91 consecutive patients from the University of Arizona Cancer Center (UACC) clinical and pathological databases, and 25 patients from the Cook County Hospital (CCH) database, seen between 2005 and 2011.The frequency of clinical characteristics and their relation to survival were analyzed and compared between UACC and CCH. Results: UACC and CCH cohorts were balanced for gender (M:F ratio 0.65) and age (median 63 y (range, 26-88), but not for race or/and ethnicity. While at CCH 36% of pts were African-American (AA), 28% Hispanic (any race), 12% Caucasian and 20% unknown; at UACC 88% of pts were Caucasian, 10% Hispanic and 1% AA (p<0.0001). UACC had 8% pts with > 1 extranodal site, while CCH had none. The primary sites of MALToma were also different. At CCH, similarly to what’s commonly reported in the literature, 40% of pts had primary gastric involvement, 20% salivary gland, 12% lung, 8% orbit, 8% thyroid, 4% intestine, 4% skull base tumor, and 4% breast. At UACC, however, 22% of pts had primary skin involvement, 19% gastric, 16% lung, 13% orbit, 8% salivary gland, 6% intestine, 5% breast, 3% thyroid and 8% other. The difference was statistically significant for the frequency of primary skin (p=0.006) but not gastric involvement (p=0.084). 80% of patients with primary skin involvement were Caucasian. The median follow-up of the survivors was 18 months for both groups, with no statistically significant difference in median progression-free (7.5 years) or overall survival (14.6 years). Conclusions: There was higher prevalence of Caucasian race and skin involvement at UACC than at CCH. We speculate that sun-induced photodamage causes chronic inflammation contributing to eventual malignant transformation to primary skin MALToma.

7558 Background: Lung cancer is the leading cause of cancer death. Response and survival of patients (pts) with stage III lung cancer in minority population is not well studied. Methods: 79 pts treated between 2001 and 2006 were studied as a retrospective cohort. Clinical and survival data were analyzed using fisher's test, chi square test, Kaplan Meier analyses. Results: 33 Pts had Stage IIIA; Median age at diagnosis was 58 yrs (37–75). 14 were males (42.4%) 19 females (57.6%) 26 African American (78.8%) and 7 Caucasians (21.2%). Median number of co morbidities 2 (0–4). Mean follow up was 25 months (mo) (2 - 93), 19 had surgery (12 Lobectomy (36.4%), 7 Pneumonectomy (21.2%)) and 14 were unresectable (42.4%). All pts received adjuvant chemotherapy. Unresectable pts received chemotherapy and radiation, 8 carboplatin and gemcitabine and 6 cisplatin and etoposide. Median time to progression in resectable IIIA was 23 mo (2- 67), unresectable IIIA was 12 mo (3–93). Median survival in pts with resection was 26 mo (2 - 67), unresectable was 12 mo (5 - 93). Overall survival and time to progression was not influenced by sex, race, tumor type. 46 pts had stage IIIB, median age at diagnosis 57.5 yrs (40–68). 31 were males (67.4%) 15 females (32.6%) 29 African Americans (63%) 11 Caucasians (23.9) 3 Asians (6.5%) and 3 Hispanics (6.5%). Median follow up was 10 mo (3–97). All pts received chemotherapy and radiation. 23 received cisplatin and etoposide (50%), 14 carboplatin and gemcitabine (30%), 5 carboplatin and etoposide (9%), 5 carboplatin and paclitaxel (9%). 13 had complete response (28.3%), 15 partial response (32.6%), 2 stable disease (4.3%) and 10 Progression (21.7%). Median time to progression was 9 mo (3–97). Median overall survival was 10 mo (3–97). Overall survival and time to progression was not influenced by sex, race, tumor type, chemotherapy regimen. Conclusions: In this minority based cohort response, time to progression, overall survival in both IIIA and IIIB pts is much lower then historical controls. The overall survival and time to progression in both IIIA and IIIB is not influenced by race, sex, tumor type and type of chemotherapy regimen. Further investigations of disease and healthcare disparities in the underserved minority population, are warranted. No significant financial relationships to disclose.