Introduction Acute myeloid leukemia (AML) is the most common acute leukemia in adults. Once diagnosed, AML is usually treated aggressively with the goal of improving survival. In this study, we aim to evaluate the factors affecting delivery of treatment in patients with AML. Methods This is a retrospective study of patients diagnosed with AML from 2003 to 2013 from the National Cancer Database (NCDB). NCDB consists of demographic variables and survival outcomes of approximately 70% of all new cancer diagnoses in the United States and Puerto Rico. Univariate logistic regression was performed to calculate crude odds ratio for different variables. Results A total of 98,293 patients were diagnosed with AML from 2003-2013, of which 24% (23,328) did not receive any systemic therapy (ST). On univariate analysis, the odds of receiving treatment were lower among females (Odds Ratio [OR] =0.97; 0.94-0.99), elderly (OR=0.15; 0.15-0.16), and Medicare patients (OR=0.23; 0.22- 0.23). Patients with one or more comorbidities had lower odds of receiving treatment compared to patients without any comorbidities (OR for 1 comorbidity=0.65; 0.63- 0.67, and OR for ≥ 2 comorbidities=0.42; 0.40-0.44). The odds of receiving ST were lower in community hospitals as compared to academic centers (OR=0.34; 0.32-0.35). African Americans had higher odds of receiving ST compared to Whites (OR=1.20; 1.13- 1.26). The patients belonging to households with higher income (>$49K) had higher odds of receiving ST (OR=1.14; 1.08-1.20). The histologic subtype associated with highest odds of receiving treatment was acute promyelocytic leukemia (OR=2.43; 2.27- 2.59). Compared to the reference period 2003-2006, patients diagnosed with AML during the later time period had higher odds for receiving therapy: 2007-2010 (OR =1.11; 1.08- 1.15), and 2011-2013 (OR=1.27; 1.22- 1.31) respectively (Table 1). Conclusions Although the number of people receiving therapy for AML has increased over time, factors like older age, comorbidities, lower household income, having Medicare, and being diagnosed at a community hospital were associated with lesser odds of receiving ST. More studies are needed to assess the impact of these factors on patient survival. Table 1. Systemic therapy in AML Variable Systemic Therapy (% of total) n = 74965 No Systemic Therapy (% of total) n = 23328 Odds ratio (95% CI) Gender Male 41 13 1.00 Female 35 11 0.97 (0.94, 0.99) Age ≤ 70 y 54 6 1.00 > 70 y 23 17 0.15 (0.15, 0.16) Race White 59 20 1.00 Black 7 2 1.20 (1.13, 1.26) Others 10 2 1.53 (1.45, 1.61) Year of diagnosis 2003-2006 24 8 1.00 2007-2010 27 9 1.11(1.08,1.15) 2011-2013 25 7 1.27 (1.22, 1.31) Insurance Private 32 4 1.00 Medicaid 7 1 1.16 (1.07, 1.26) Medicare 29 17 0.23 (0.22, 0.23) No Insurance 3 1 0.61 (0.55, 0.66) Others 5 1 0.61 (0.57, 0.66) Household income < $28K 7 2 1.00 $28K -$32,999 10 3 1.04 (0.98, 1.11) $33K - $38,999 14 5 1.01 (0.95, 1.08) $39K - $48,999 18 6 1.05 (0.99, 1.11) $49K + 27 8 1.14 (1.08, 1.20) Comorbidity None 58 15 1.00 Only 1 comorbid condition 14 5 0.65 (0.63, 0.67) Two or more comorbid conditions 5 3 0.42 (0.40, 0.44) Histology Acute Myeloid Leukemia (AML) 42 16 1.00 Acute Promyelocytic Leukemia (APL) 8 1 2.43 (2.27, 2.59) Acute Myelomonocytic Leukemia (AMyL) 6 2 1.25 (1.18, 1.32) Acute Myeloid Leukemia with Multilineage Dysplasia (AMLMD) 5 2 1.11 (1.05, 1.18) Acute Myeloid Leukemia with Maturation (AMLM) 4 1 1.56 (1.44, 1.68) Acute Myeloid Leukemia without Maturation (AMLWM) 3 1 2.02 (1.85, 2.21) Acute Myeloid Leukemia, Minimal Differentation 2 1 0.98 (0.91, 1.06) Other Specified Types (OST) 2 1 1.23 (1.11, 1.36) Erythroleukemia 2 1 1.07 (0.97, 1.18) Facility Type (n= 83431) Academic 50 8 1.00 Community 29 13 0.34 (0.32, 0.35) AML: Acute myeloid leukemia Disclosures No relevant conflicts of interest to declare.

Background: BPDCN is a rare subtype of aggressive acute leukemia that usually has an indolent clinical presentation such as isolated solitary or multiple cutaneous lesions. Despite initial clinical responses to systemic chemotherapy, BPDCN follows an aggressive course with a reported median OS of approximately 8-14 months based on single-center studies. We aimed to determine the OS of BPDCN and its predictors utilizing a US population-based database. Methods: Using International Classification of Disease for Oncology, 3rd edition (ICD-O-3) code 9727/3, SEER 18 database was analyzed to identify adult patients with BPDCN diagnosed from 2001-2012. We divided the entire cohort into 3 groups based on time periods of 4 years each (2001-2004, 2005-2008, 2008-2012) to represent early (E), middle (M) and late (L) cohorts. Age, sex, race, marital status, radiation use, and OS were compared across the three time periods. Multivariate analyses of OS were performed using Cox regression to adjust for significant covariates. A p-value of <0.05 was considered statistically significant. Results: Of 417 patients, the majority were males (67%), patients aged ≤ 60 years (75%) and whites (82%). A higher proportion of patients were diagnosed in the early time period (E=43% vs. M=29% vs. L = 29%). About a sixth of the cohort (17%) received radiation therapy. Median OS was not reached for the cohort. Five-year OS was higher for patients ≤ 60 years, as compared to patients >60 years (70% vs. 50%, p<0.01). On a multivariate analysis, age >60 years (hazard ratio, HR 2.05; 95% confidence interval, CI 1.28-3.27, p <0.008) and African American ethnicity (HR 1.79; 95% CI 1.10-2.89, p=0.018) were associated with a higher hazard for death whereas OS did not differ based on sex, marital status, time period, or the use of radiation therapy. Of the 106 patients >60 years, the majority were males (68%), whites (93%), married (74%), and did not receive radiation (92%). On a multivariate analysis after adjusting for age, sex, race, time of diagnosis, and radiation therapy, being single (marital status) was associated with a worse OS (HR2.24; 95% CI 1.05-4.77, p=0.034) among patients >60 years. Conclusions: To our knowledge, this is the largest and most recent population-based study in BPDCN. Compared to prior single-center studies, our results demonstrate much better OS. Older age and African American ethnicity are determined to be negative prognostic factors for OS. Single older patients are at even a higher risk of mortality. The study findings may help in patient counseling and informed decision-making. Racial disparities in OS require further investigation. Disclosures No relevant conflicts of interest to declare.

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Background The treatment of Crohn’s stenosis appears to be codified and complex, it depends on the inflammatory or fibrous type of stenosis. The purpose of our study was to describe the clinical, epidemiological and therapeutic characteristics of Crohn’s disease in its stenotic form and to determine the failure factors for the treatment of stenotic CD. Methods This is a descriptive and analytical monocentric retrospective study, involving 900 Crohn’s patients, 189 of whom had stenotic CD. The statistical analysis is performed using the SPSS 22.0 software. Results The average age was 32± 11 years. Followed for an average of 48 months[12–96].Sex ratio=1.14F/1H. 44(23.3%) were smokers and 29(15.3%) had a previous of appendectomy.Symptomatology was Koenig syndrome in 107 cases(56.6%), occlusive syndrome in 40 cases(21.2%), constipation in 31 cases(16.4%), vomiting in 7 cases(3.7%) and 4 cases(2.2%) asymptomatic.The localisation of stenosis was ileocaecal in 118 patients(62.4%), hail in 32 patients(16.9%), colic in 17 cases(9%), anal in 15 cases(7.9%) and high in 7 cases(3.7%).Stenosis was unique in 160 cases(84.7%) and multiple in 29 cases(15.3%). 117 patients (62%) had a short stenosis &lt;5 cm and 72 patients (38%) had a stenosis &gt;5 cm. The fibrous nature of stenosis was in 86 patients (45.5%) and inflammatory in 103 (54.5%). 40 patients (21.2%) had an associated fistulizing behaviour. Anoperineal manifestations (MAP) in 58 cases (30.7%). Therapeutically speaking:80 patients (42.3%) were treated with corticosteroids, 10 patients (5.3%) with anti-TNFa, 3 patients (1.6%) with immunosuppressants (IS), 12 cases (6.3%) with endoscopic dilation and 84 cases (44.4%) were operated. The course was marked by a good response in 53 cases (28%), the appearance of fistula± abscess in 25 cases (13.2%), intestinal obstruction in 13 cases (6.9%) and recurrence of stenotic disease in 98 cases (51.9%).There is a difference in management between fibrous and inflammatory stenosis:corticosteroids(1.2%vs98.8%),anti-TNF(10%vs90%), dilation(100%vs0%), surgery(84.5%vs15.5%), this difference is statistically significant(p &lt; 0.001). In multivariate analysis and by adjusting for confounding parameters, it appears that only MAP, ileocaecal location and fistulizing behavior are associated with treatment failure with [OR = 3.2; IC = 1.4–7.7; p = 0.005], [OR = 0.17; IC = 0.3–0.9; p = 0.037], [OR = 2.6; IC = 1.02–6.6; p = 0.04]. Conclusion There was a statistically significant difference (p &lt; 0.001) in terms of response to corticosteroid and anti-TNF treatments, as well as the use of surgery and dilatation between fibrous and inflammatory stenosis. And treatment failure was related to: MAP association [OR = 3.2; IC = 1.4–7.7; p = 0.005], ileocaecal localisation of stenosis [OR = 0.17; IC=0.3–0.9; p = 0.037] and fistulizing behavior[OR = 2.6;IC = 1.02–6.6;p = 0.04]