Introduction: Chronic lymphocytic leukemia (CLL) is the most frequent leukemia of the adult in Europe and North Africa. It is rare on the Asian and African continents. It affects mainly elderly people over 60 years. The main objective is determining the rate of average annual incidence, and secondly establishing the distribution of this complaint according to the different health regions of the country and precise the epidemiological characteristics. Patients and Methods: It is a national, descriptive, retrospective epidemiological study carried out for a period of 05 years : from January 2009 to December 2013. Information collection is done thanks to the setting up of a technical data sheet sent out to the appropriate services. This technical data sheet is about the geographic data of the patient (place of birth, place of residence, place of taking charge of the disease and the date of the diagnosis), anthropologic data (age at the diagnosis, sex), as well as the clinico-biological data. The working of the responses was done on SPSS 19 .0. In our study, the diagnosis is carried before an hyperlymphocytosis > 5000/ mm3, a cytological examination of the blood smear and an immunophenotyping operation by cytometer operation in flow. Results: 17 hematology departments have participated in this study with 1210 cases listed, of which 68,1% (824 pts) are men. The average annual recruitment is of 242 cases. The average annual incidence rate, calculated according to the data of the national statistics office is estimated at 0,66 / 100.000 inhabitants.This incidence does not increase over the years and stays relatively stable (2009 = 0,67; 2010 = 0,57; 2011 = 0,63; 2012 = 0,67; 2013 = 0,74/100.000 inhts). The geographic distribution of the pts according to their places of residence, shows that the majority among them are from the north of the country particularly the center (0,80/100.000 inhts). Incidence increases over age, going among men from 0,06 for 100.000 inhts between 30 - 39 years to 11,94 / 100.000 inhts at 80 years and over and among women from 0,04 for 100.000 inhts to 6,08 for 100.000 inhts. The average incidence rate is of 0,85/100.000 inhts among men and of 0,42/100.000 inhts among women. The average age at the diagnosis is of 67,5 years (33 - 98 years). 30,1% (365 pts) incident cases are observed among the patients over 75 years and 14,1% (171 pts) among the patients below the age of 55 years. The profession that is most found is farming 12.2% (78/635 precised). The diagnosis is late in Algeria, the first symptome which brings the patient to consultation is the tumoral syndrome (44% (363 / 825 precised)) in an average diagnosis period of time of 07 months (01 - 96 months). The stage C (classification of Binet) is equally predominant, found in 41,1% (492 / 1172 precised). In terms of biology : the average rate of lymphocytes is of 92500/mm3 (5000-900 000/mm3). The morphological study on blood smear finds 88,2% (1066 / 1208 precised) of typical CLL and 50% of Gambrest cells. The cytometer operation in flow done in 746 cases (61,6%) shows a score of matutes > 4 in 92,3% and in 7,7% is equal to 3. the cytogenetic operation (Caryotype and Fish) done in only one hematology department (CAC of Blida) among 102 patients (8.4%). Comments: The rate of incidence in Algeria is weak compared to that of other countries. The rate of incidence standardized to the world population is of 0,52 cases/100.000 inhts and to the European population is of 0,68 cases p 100.000 inhts. The young age of the population may explain this incidence and that some patients at the stage A are not diagnosed. The CLL affects more frequently men. The average age at the diagnosis is of 67,5 year. However, 30,1% of the incident cases are observed among the patients over 75 years in Algeria versus 45 à 50% of incident cases in Europe and this may be explained by the young age of our population. The CLL are placed 5th among the malignant hemopathies: the rate of incidence for the year 2009 : LNH = 1.96; LH = 1.2; MM = 0.96; AML = 0.85; CLL = 0.67; CML = 0.44; ALL = 0.32. Conclusion: the CLL can be diagnosed and differentiated from the other lymphoproliferative syndromes thanks to the morphological examination of the lymphocytes at the blood smear completed by an immunophenotyping operation of the peripheral blood . This study represents only an epidemiological approach of the CLL in Algeria. The incidence is still weak in our country; it affects as in the other countries the elderly people with a masculin predominance. Disclosures No relevant conflicts of interest to declare.

Introduction : Among genetic diseases in hematology, β Thalassemia ranks second after sickle cell disorders in Algeria. Given the seriousness and cost of the care that arises, a national action plan is needed. As a starting point, a national survey is essential to know the epidemiological situation of this disease. Objective : To determine the soci-demographic, diagnosis and evolution characteristics of major and intermediate thalassemia in Algeria. Materiels and Methods : This is a multicenter, retrospective, analytical study of 775 patients with thalassemia major (TM: 598 cases) and intermediate (TI: 177 cases). This national survey is representative of 21 services (Hematology: 19, Pediatrics: 03). The data was collected from medical records on a survey card distributed to all relevant services. Results : As of January 1, 2017, the prevalence of β Thalassemia estimated from this study is of the order of 3.47 cases per 100 000 inhabitants. The current average age of major thalassemia (MT) is 17.90 years, with extremes of [1-44 years], that of intermediate form (IT) is 23 years old with extremes of [1-61 years], the sex ratio is 1.15. The concept of consanguinity is specified in 499 patients and is present in 49.30% of cases, the geographical origin of patients is variable, 53% are from the center of the country and 43% from the east. The circumstances of the diagnosis are known in 87.25% of subjects, these are clinical symptoms in 93.91% of patients, with an average age at diagnosis of 16.31 months for MT and 5.5 years for IT. The diagnosis is neonatal in only 5.68% of cases. Blood cells transfusion needs are known in 80% of our cohort, 86% receive a systematic and regular diet; 554 patients are on chelation therapy, the main modality being deferoxamine or Deferasirox type monotherapy. 40 MT patients received Hematopoetic Stem Cell Transplantation. The monitoring of iron overload was based mainly on the determination of ferritinemia, only 8.8% of patients received cardiac and hepatic MRI. Various complications associated with iron overload have been reported, the most common being: Hepatic injury (48%), heart disease (36%), diabetes (30%), hypothyroidism (29.17). %), with average ages of onset of 26.67, 18, 19, and 14.50 years, respectively. In addition, viral serology was performed in 536 patients, 64 (11.9%) of whom were carriers of anti-HCV Ab. Conclusion : The quality and life expectancy of thalassemic patients has improved significantly in recent years; complications related to iron overload remain the leading cause of death, the means of evaluation remain insufficient in our country. In addition, the care of our patients must be standardized on the national territory. Disclosures No relevant conflicts of interest to declare.

Introduction: Chronic myeloid leukemia (CML) accounts for 7%-15% of all leukemias affecting adults. The incidence in Algeria is 0.4/100,000 inhabitants in 2009. The aim of this study is to establish an Algerian-Tunisian epidemiological approach of CML and to know the characteristics of the disease in both countries. Materials and methods: This is a retrospective, longitudinal and multicenter study, including Algerian and Tunisian patients with CML diagnosed between January 2010 and December 2014. Through a data form distributed to various hematology departments, we collected and analyzed the following information: Patient's general characteristics, profession, circumstances of discovery of the disease, clinical and para-clinical examinations outcomes at the time of diagnosis including blood count, blood smear, bone marrow aspiration, cytogenetics, molecular biology, stages of the disease and the Sokal and Eutos prognostic classification scores. Bio-statistical tests: incidence, prevalence and rate of prevalence or relative prevalence (reported to 100,000 inhabitants / year). The descriptive analysis of quantitative and qualitative variables as percentages and 95% confidence interval. The Chi2 test is used to compare two variables. Results: We collected 1349 cases, including 325 from 06 Tunisian hematology units and 1024 from 18 Algerian units. The incidence in the Algerian-Tunisian population was 0.67/100,000 inhabitants with a prevalence rate of 2.72/100,000 inhabitants. The incidence in Tunisia was 0.50 / 100,000 inhabitants with a prevalence of 227 cases in 2014. In Algeria the incidence was 0.53/100,000 inhabitants with a prevalence of 1030 in 2014. The median age is 48 years (03-90) with a peak incidence in the age group (45-49 ans) and slight male predominance (sex ratio: 1,2). There was any notion of risk exposure. The average time between the start of the unrest and the date of diagnosis is 127 days (1-667). The circumstances of discovery: fortuitous in 30.5% (n = 355), splenomegaly in 39.7% (n = 463), asthenia in 24.6% (n = 287), a complication in 8.4% (n =95). Clinical examination includes general signs in 424 cases (36.4%): Weight loss 22.6% (n = 263), profuse sweating 13.8% (n = 13, 8%), bone pains found in 7.8%, splenomegaly in 81.7% (n = 952) with an overhang splenic average of 11.5 ± 5.3 cm (1-28), cutaneous and subcutaneous bleeding: 13.5% (n = 97), thrombosis 0.9% (n = 09). Biological characteristics: the Complete blood count (n = 1185) shows a white blood cells average rate of 171,223 G/L (34,700-984,800), hemoglobin average rate of 10.2 g/dl (4-17), platelets at 394,070 g/l (85-1340). Blood smear 96.3% (n = 1121): the average myelemia was 43.2% (10-98%). The Myelogram is practiced in 55% (n = 641), the average rate of the granular 76,5% (40-99%), erythroblasts 10.5% (0-82%), average blasts 3.6%. The karyotype 38.1% (n = 444), the Philadelphia chromosome was found in 423 cases (95, 3%); additional abnormalities were found in 17 cases (3.8%). The Fish was practiced in 281 cases (24.1%) and transcribed bcr/abl was found in 257 cases (91.4%). Molecular biology is practiced in 672 cases (57.7%) the transcript bcr/abl is found in 100%, the transcript of the type is specified in 373 cases, it is kind of b2a2 in 159 cases (42.6%), a b3a2 type in 180 cases (48.3%) and other transcribed in 34 cases (9.1%). CML chronic phase is diagnosed in 88.8% (n = 1051), acceleration phase in 9% (n = 107) acutisation phase in 3.1% (= 37). The distribution of pts according to Sokal prognostic classification (n = 948) describes a predominance of intermediate risk in 54% (n = 511), high risk in 30.3% (n = 287) and low risk in 16% (n = 152). The Eutos score is specified in 769 cases (66%), it is less than 87 in 661 cases (86%) and more than 87 in 108 cases (14%). Conclusion: The incidence of CML in the Algerian-Tunisian population is 0.67/100,000 population with a prevalence rate of 2.72/100,000 inhabitants. The young adult is more affected with a peak incidence between 45 and 49. The average time between the onset of the disease and the diagnosis remains long and the delay probably explains the frequency of tumor forms encountered in Algeria and the prevalence of high and intermediate risk, according to Sokal prognostic classification. Disclosures No relevant conflicts of interest to declare.

Introduction: Primitive extranodal lymphomas are a heterogeneous group of malignant lymphoid hematological developed from the mucosa-associated lymphoid tissue (MATL) or sites that have acquired MALT after repeated stimulation. The particularity of this type of affection reside: the access to diagnosis which is difficult and therapeutic approach which respond to the ATB, antiviral, surgery and RT. They represent 24-48% of lymph node lymphomas and they are increasing. The incidence of lymphoma is growing in the world, it is approximately 16.8 / 105inhabitants. In Algeria in 2012, the incidence of lymph node lymphomas in adults was 2.24 / 100,000. Lymphomas Diffuse large B-cell phenotype (DLBCL) represent 50-60% of lymphomas, it is the most common histological type. Goals of the study: 1-analyze the epidemiological characteristics (gender, age, geographical distribution, annual incidence). 2- Identify anatomical sites. 3- Specify the clinical and prognostic features Patients and methods: It's is a multicenter, retrospective study over a period between 2010-2014. The study population included all pts over 15 years and having an extranodal DLBCL at 18 hematology centers and 4 cancer centers. Data were collected on data sheets distributed to the various services involved in the study. The diagnosis is made on the histological examination of a biopsy of the affected organ. The clinical, biological and imaging results allowed us to classify and identify prognostic factors for pts. Results: Among 1057 sheets of extranodal lymphomas, the type DLBCL is specified in 562 (53%) cases, distributed in 325 men and 237 women (sex ratio M/F: 1.36). The average age at diagnosis is 51 years (16-88) with a peak in the age group 50-60 years. The overall annual incidence of 0.31/105 inhabitants/year and the specific incidence for patients over 15 years is 0.42 / 105inhabitants/year. PS 0-1: 323 / 543pts (60%). Number of pts (pts) by place of care: Annaba 65, Sétif: 60, CAC Constantine: 53, Tizi Ouzou: 49, Blida Cac: 41, CMPC-hematology: 40, Tlemcen: 30, Beni- Méssous- hematology: 29, CAC CPMC: 24, EHUOran: 23, hematology CAC Batna: 22, CHU Oran: 19, HMRUO: 17, Blida-hematology: 16, HCA:16, SBA: 15, CAC Béni-Messous: 14, EPH Mascara: 10, HMRU Oran: 9, Bejaia: 7, hematology CHU Batna: 2, hematology Cne:1. Number of cases according to anatomical localisation: Stomach: 180, Intestine: 31, Colon 12, Tonsils: 70, Cavum: 31, nasal cavities: 11, Bones: 43, mediastinum: 41, SNC: 29, Skin: 25, Rate / MO :15, Thyroid: 12, soft Parties: 10, Breast: 6, lung / pleural: 5, Liver: 5, Others: 36. The clinical symptomatology is very heterogeneous, specifically of the affected organ. Clinical stage is specified in 549 cases, according to Ann Arbor: SCIE: 272 (49%), SCIIE: 149 (27%), SCIIIE: 31 (6%), SCIV: 97 (18%). The International Prognostic Index adjusted for age (IPIaa) include: for pts less than 60 years: Low (F): 70 (23%), lower intermediate (IF): 130 (43%), intermediate high (IE) : 69 (23%), high (H): 32 (11%); for over 60 years Topics: F: 33 (23%), MI: 53 (37%) IE: 41 (28%), E: 17 (12%). Comments: As with other types of lymphoma, there is a male predominance and a peak incidence in the age group 50-60 years. The higher number of pts in the center and east of the country is probably related to a denser population in these regions. The histological type DLBCL at 53% is in agreement whith what it is conventionally reported. The incidence of 0.31/105inhabitants/year extranodal DLBCL is lower than the overall nodal DLBCL, however, the incidence of extranodal NHL is rarely determined. The number of cases of extranodal lymphomas described in this study is certainly below the actual number because this group of disorders is supported by various specialties related to the location of lymphoma. Extranodal lymphomas has a clinical polymorphism, but it is recognized that gastric and tonsillar locations are the most common, the other despite their rarity, require attention from management. This type of lymphoma is characterized by a preponderance of localized stages unlike ganglion lymphomas where the extended stages predominate. Likewise distribution by IPIaa not exceeding one pejorative factor is more common. Conclusion: Extranodal DLBCL are rare, they are characterized by a diversity clinicopathological that challenges us to homogenization of their treatment in multidisciplinary level. Disclosures No relevant conflicts of interest to declare.

BACKGROUND: In Algeria, the incidence of hematologic malignancies has been difficult to estimate for many years and MDS incidence is unclear because of historical lack of population-based registration and possibly because of under diagnosis. Today, many hematological centers, including 17 university hospitals, have been developed in the entire north and have useful epidemiological data pertinent to MDS. We studied the incidence of MDS and its subtypes, age distribution, geographic distribution and trends in the rate of diagnosis over the last 5 years in Algeria. DESIGN AND SETTING: Retrospective analysis of nationwide survey of all adult cases of MDS (>16 years) diagnosed between January 2010 and 31 December 2014. PATIENTS AND METHODS: Patients diagnosed with MDS and referred to all departments of hematology at the 17 participating centers between 2010-2014 were identified. Complete demographic and clinical data, laboratory results, treatment modalities were collected and analyzed. RESULTS: Between 2010 and 2014, a total of 243 patients with newly diagnosed MDS have been identified. The sex ratio (M/F) is: 1:08, and the median age is 64.3 years (16 - 82 years). Globally, 27% of MDS are diagnosed in the whole Western region of the country, 56% in the Centre, 14% in the East and 3% in the south. The crude mean annual incidence rate of MDS was 0.07 per 100,000 inhabitants aged ≥15 years old. 11.2% patients were less than 45 years and 42% were older than 70 years.4.3% patients were from rural areas and 6, 2 % were cigarette smokers. Mean hemoglobin level was 7.8 g/dl, mean WBC level was 6134/µl, mean platelets level was 134907/µl, mean VGM level was 92.7 fl and mean ferretin level was 739.31 ng/ml. The mean blood transfusion units were 13.5 units. 36.3% patients had RCMD, 15.9% had RAEB2 and 13.2% had RAEB1. 34.4% patients had cytogenetic abnormalities, and del-5q was more commonly encountered in 22.7%. The IPSS-R was very low in 18.3%, low in 18.3%, intermediate in 11.8%, high in 7.5% and non-specified in 36.6%. Treatment regimens were supportive care (transfusion RBC with chelation, and platelets) and growth factors (EPO, Romiplostine, and G-CSF). At the date of end point, 44% of patients were alive, 26% were death and 31% were lost of follow up. CONCLUSION: Epidemiologic features of our patients are different from the occidental ones. Mean age of presentation of MDS in Algeria is lower than developed countries. The relatively younger age of patients compared to the Western countries may be due to the demographic composition of our population. The annual incidence is still low, but a continuously increasing incidence rate of MDS has been observed throughout the study period and an overall increase in the number of MDS patients diagnosed nationwide over the last five years indicates a need for additional health care resources including curative and therapy-intense strategies, such as stem cell transplant facilities to optimize outcome. Refractory anemia was the most common subtype in both FAB and WHO classification systems and in both genders. The best supportive care was used in all patients in first line treatment and the Iron overload is a permanent feature of MDS. Disclosures No relevant conflicts of interest to declare.