Background: COVID-19 is a condition caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing a systemic inflammatory response and respiratory failure. Patients with acute leukemia are presumed to be at the highest risk among all cancer patients, given their state of severe immunosuppression from both the disease and aggressive therapy. Therefore, we aimed to determine if COVID-19 increases the early-mortality risk of ALL patients during the induction phase. Methods: We conducted a retrospective cohort study by reviewing medical records of newly diagnosed ALL patients between March 2020 and September 2020 at a single Peruvian institution (INEN, Lima-Peru). We included patients older than 14 years, with the initial intent of intensive treatment. The proposed protocol was the CALGB10403 with asparaginase modification. COVID-19 was determined by a +ve nasopharyngeal SARS-CoV-2 RT-PCR or serology. The outcomes were 30-day and 60-day mortality and treatment response at the end of induction. Results: Of 63 patients with ALL in induction therapy, 22 (35%) had COVID-19, and 41 (65%) did not. Overall, the median age was 30 (IQR 21 - 42), and 59% were males. Table 1 shows that age, sex, ALL subtype, and laboratory characteristics had a similar distribution between both groups. The mortality rate of ALL patients with COVID-19 was non-statistically different from non-COVID-19 patients at 30 (23% versus 12%, p=0.466) and 60 days (32% versus 20%, p=0.434). Multivariate logistic regression did not find a significant association between COVID-19 and complete treatment response (aOR: 0.44, 95% CI: 0.02-4.54). Similarly, patients with COVID-19 did not had an increased mortality risk at 30 days (aHR: 2.37, 95% CI: 0.64-8.75) and 60 days (aHR: 1.98, 95% CI: 0.7-5.64). Conclusion: In our cohort, COVID-19 did not increase the risk of early death in newly diagnosed patients with ALL. Table 1.Characteristics of patients with ALLOverallCOVID-19 NegativeCOVID-19 positivep-value*n=63n=41n=22Age (years)**33 ±1532 ±1635 ±130.377Sex Male37 (59%)25 (61%)12 (55%)0.821 Female23 (41%)16 (39%)10 (45%)Type B-ALL56 (86%)36 (88%)18 (72%)0.787 T-ALL9 (14%)5 (12%)4 (18%)B-ALL subtype NOS42 (78%)29 (81%)13 (72%)0.873 E2A/PBX12 (4%)1 (3%)1 (6%) MLL/AF42 (4%)1 (3%)1 (6%) TEL/AML1 (2%)1 (3%)0 (0%) BCR/ABL5 (8%)3 (7%)2 (10%) Unknown2 (4%)1 (3%)1 (6%)DHL (U/L)655 ±854719 ±988536 ±5230.422D-dimer (ng/mL)4539 ±59085319 ±70293164 ±27290.184Leucocytes (x103µL)38 ±10044 ±11927 ±490.528Hemoglobin (g/dL) †9 (7-14)9 (7-11)10 (7-54)0.475CNS Infiltration11 (17%)8 (20%)3 (14%)0.812ECOG>32 (3%)1 (2%)1 (5%)Complete Response43 (68%)28 (68%)15 (68%)0.896Minimal Residual Disease29 (46%)20 (49%)9 (41%)0.8330-day mortality10 (16%)5 (12%)5 (23%)0.46660-day mortality15 (24%)8 (20%)7 (32%)0.434*Univariate Cox regression.**Mean (standard deviation)†Median (Interquartile range) Citation Format: Daniel J. Enriquez-Vera, Ali Al-kassab-Cordova, Lizbeth Lachira-Yparraguirre, Gustavo Sandival-Ampuero, Bryan Valcarcel, Cesar Samanez, Juan Haro-Varas, Shirley Quintana-Truyenque, Luis Malpica, Henry Gomez-Leonidas, Tatiana Vidaurre-Rojas. Early death in acute lymphoblastic leukemia during COVID-19 pandemic: A single institution cohort study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 721.

Background: Acute myeloid leukemia (AML) is a highly heterogeneous disease with new cases commonly diagnosed in the elderly population. Despite advances in AML therapy, disease outcomes remain poor. Between 2010 and 2016, the reported 5-year overall survival in the U.S. was 28.7% (Source: NCI SEER 13 statistics). National based registries are vital to monitor the incidence, outcome and survivorship of AML patients. Therefore, we aim to explore the incidence and outcome of AML patients managed at the National Cancer Institute in Peru over the past decade. Methods: We conducted a retrospective analysis of all newly diagnosed AML patients seen at the National Cancer Institute (INEN) in Lima-Peru between January 2008 to December 2018. The INEN is the major governmental leukemia center providing care for about 60% of newly diagnosed AML patients in Peru. Patient eligibility screening was performed using the Flow Cytometry Core Lab Registry. We excluded patients with acute promyelocytic leukemia. Demographic and clinical characteristics were obtained from medical records. Place of birth and death records were confirmed using the Peruvian National Registry of Identification and Civil Status (RENIEC). Survival analysis was performed using Kaplan Meier and Log-rank tests. The cumulative 11-year AML incidence rate was calculated and plotted using a choropleth map of Peru. Results: A total of 1,499 newly diagnosed AML cases were identified and had sufficient data for analysis. Median age at diagnosis was 44 years (range: 0-92) with a female:male ratio of 0.9:1. Clinical characteristics and outcome are presented in Table 1. Twenty-two percent (n=324) of patients were older than 65 years-old at the time of diagnosis. Most patients (n=926, 62%) came from the coastal region of Peru, followed by the mountains (30%) and the rainforest (8%). The cumulative 11-year incidence rate according to geographical location is shown in Figure 1. Overall, the Peruvian hospital-based cumulative incidence rate was 4.79 AML cases per 100,000 habitants, with the highest incidence rate observed in Piura (a coastal city in Northern Peru) with 38 AML cases per 100,000 habitants. At a median follow up of 68 months, the global 5-year overall survival (OS) rate of AML cases seen in Peru was 16%. Worse survival rates were found in patients aged 66 years and older (5-year OS 3%, median survival time [MST] 2 months, p<0.001), followed by patients aged 46 to 65 years (5-year OS 9%, MST 2 months, p<0.001) (Figure 2). Better survival rates were observed in children and adolescents (5-year OS 43%, MST 18 months, p<0.001) and in patients coming from the rainforest of Peru (5-year OS 26%, MST 9 months, p<0.001) (Figure 2). No differences on survival were found when comparing by gender and year of diagnosis (Table 1). Conclusions: This is the first study describing the incidence and outcome of AML patients in Peru. In this large contemporary cohort, we found a cumulative 11-year incidence rate of 4.79 AML cases per 100,000 habitants, with an alarming high incidence of AML cases observed in the city of Piura which needs further epidemiological evaluation. Despite improvements in supportive care in the contemporary era, our inpatient mortality for adult patients with AML remains high particularly among older patients. Further analyses are warranted to examine predictors of AML-related deaths in Peru and to develop strategies that improve patient outcomes. Disclosures No relevant conflicts of interest to declare.