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Background Multiple myeloma (MM) is a heterogeneous and incurable disease that evolves from asymptomatic premalignant conditions. The worldwide incidence, prevalence and mortality are well known thanks to data reported by the International Agency for Research on Cancer (IARC) and by the GLOBOCAN World Cancer Observatory. The data provided by Colombia to these reports comes from the population cancer registries corresponding to 5 cities whose most up-to-date data are from 2018. National data can also be found in the base of the high-cost account. Although it is true that there are excellent sources of information, it is believed that there is a significant underreporting of the prevalence of the disease, which makes it necessary to optimize the information to achieve the establishment of programs oriented to work on better control of this type of hematological cancer. The study MiMENTe (Mieloma Múltiple Epidemiología Nacional y territorial) is a collaborative effort to know the reality of the disease in terms of incidence, prevalence and mortality in Colombia as a first step to control the disease even in the premalignant stages for the future wanting to position itself as a model for the control of MM in developing countries. Methods MiMENTE (Mieloma Múltiple, Epidemiología Nacional y territorial) is a multiphase study that is going through its first stage through a cross-sectional study in Colombia. The total population diagnosed with Multiple Myeloma (ICD Code 10 C900) during the 2008-2018 period was included in the RIPS Individual Service Delivery Registry in Colombia and a comparison was made with the available data from GLOBOCAN (Global Cancer Observatory) and High Cost Account. Records that had an unidentified diagnosis were excluded. For this phase, a comparison is made of the data from the registries of the three entities described, three measures of frequency are established: Incidence, prevalence and mortality, standardizing the latter by means of a direct method, making the Colombian population comparable with large countries such as the United States. and Spain cataloged as centers of reference in the management and diagnosis of Multiple Myeloma. Variables such as ethnicity, age, place of origin, health regime, place of death will be studied in the future in later phases of the study. Results Between 2009 and 2018 (10 years), 26,356 MM diagnoses were found throughout the national territory of Colombia. The departments where the most attention to patients with this diagnosis was presented were Cundinamarca, Valle del Cauca, Antioquia, Santander, Bolívar and Atlántico Figure 1. The standardized incidence rate for Colombia in 2018 was 1.79 x 100,000 inhabitants, being higher in the Andean region as shown in the heat map. Graph 1. The total number of prevalent cases per year varied from 1138 cases in 2009 to 4474 cases in 2018 being for this year the adjusted prevalence of 8.97 x 100,000 inhabitants / year Graph 2. When the prevalence is analyzed by regions it is higher in the Andean region Graph 3. During this entire period of time, 5481 deaths were found, being 20.80%. The highest mortality occurred in the departments of Vichada, Meta, Caquetá, Risaralda, Atlántico and the island of San Andrés. Figure 2. The age-standardized mortality rate for Colombia is 1,39x100,000 inhabitants (Adjusted with the population of the United States). The most up-to-date data from IARC and GLOBOCAN are those corresponding to the year 2018. A comparison was made of our data with those reported in this last registry for Colombia in addition to the high-cost account. Comparative data were developed with the population of the United States, standardizing this population and it was also compared with the data reported for Spain. The prevalence of the disease is higher in Colombia than reported by GLOBOCAN, IARC and High cost drug account Table 1. Conclusion This is the first report of the MiMENTe study that shows the incidence, prevalence and mortality of patients with 10-year-old multiple myeloma in Colombia. The prevalence of the disease is higher than that reported by international registries. The regions with the highest incidence were those belonging to the andean region. The highest prevalence was confirmed in Bogotá and Antioquia and the highest mortality was observed in the Orinoco region. Disclosures Idrobo: Takeda: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Tecnofarma: Honoraria, Speakers Bureau; Amgen: Honoraria, Speakers Bureau; Abbvie: Honoraria, Speakers Bureau.

Introducción y objetivos: el mieloma múltiple (MM) es una enfermedad heterogénea e incurable que evoluciona a partir de condiciones premalignas asintomáticas. La incidencia, prevalencia y mortalidad a nivel mundial son conocidas gracias a los datos reportados por la Agencia Internacional para la Investigación del Cáncer (IARC) y por el Observatorio Mundial del Cáncer GLOBOCAN. Los datos que brinda Colombia a estos informes provienen de los registros de cáncer poblacional correspondientes a cinco ciudades, cuyos datos más actualizados son de 2018. Los datos nacionales también se pueden encontrar en la base de la cuenta de alto costo en la cual se informó que para el 2018 el MM fue la enfermedad más prevalente entre las neoplasias hematológicas, superando incluso a los linfomas. Si bien es cierto que existen excelentes fuentes de información, se cree que existe un subregistro significativo de la prevalencia de la enfermedad, lo que hace necesario comparar la información disponible para tener información más certera, orientada al establecimiento de programas del control de la enfermedad. Este estudio es un esfuerzo colaborativo que tiene como objetivo conocer la realidad de la enfermedad en términos de incidencia, prevalencia y mortalidad, comparando las distintas fuentes de información en Colombia, como un primer paso para controlar la enfermedad incluso en las etapas premalignas para posicionarse a futuro como modelo para el control de MM en países en desarrollo. Materiales y métodos: este es un estudio multifásico que atraviesa sus primeras etapas. El presente informe corresponde a un estudio de corte transversal en Colombia. La población total diagnosticada de mieloma múltiple (Código CIE 10 C900) durante el período 2008-2018 se incluyó en el Registro de Prestación de Servicios Individuales (RIPS) en Colombia y se comparó con los datos disponibles de GLOBOCAN y la cuenta de alto costo. Se excluyeron los registros que tenían un diagnóstico no identificado. Para esta fase se comparan los datos de los registros de las tres fuentes descritas. Se establecen tres medidas de frecuencia: incidencia, prevalencia y mortalidad, estandarizando esta última mediante un método directo, haciendo que la población colombiana sea comparable con países grandes como los Estados Unidos y España, catalogados como centros de referencia en el manejo y diagnóstico del mieloma múltiple. Variables como etnia, edad, lugar de origen, régimen de salud, lugar de muerte serán estudiadas en fases posteriores del estudio. Resultados: entre 2009 y 2018 (10 años) se encontraron 26.356 diagnósticos de MM en todo el territorio colombiano. La tasa de incidencia estandarizada para Colombia en 2018 fue de 1.79 x 100.000 habitantes, siendo mayor en la región andina como se muestra en el mapa de calor (Figura 1). El número total de casos prevalentes por año varió de 1138 casos en 2009 a 4474 casos en 2018, siendo para este año la prevalencia ajustada de 8.97 x 100.000 habitantes/año (Figura 2). Cuando se analiza la prevalencia por regiones es mayor en la región andina (Figura 3). Durante el período de tiempo estudiado se encontraron 5481 muertes, siendo el 20.80 %. La mayor mortalidad se produjo en los departamentosde Vichada, Meta, Caquetá, Risaralda, Atlántico y la isla de San Andrés (Figura 2). La tasa de mortalidad estandarizada por edad para Colombia es de 1.39 x 100.000 habitantes (ajustada con la población de Estados Unidos). Los datos más actualizados de IARC y GLOBOCAN son los correspondientes al año 2018. Se realizó una comparación de nuestros datos con los reportados en este último registro para Colombia, además de la cuenta de alto costo. Se desarrollaron datos comparativos con la población de Estados Unidos, estandarizando esta población y también se comparó con los datos reportados para España. La prevalencia de la enfermedad en Colombia es más alta que la reportada por GLOBOCAN, IARC y la cuenta de medicamentos de alto costo. Conclusión: en este primer informe se muestra la incidencia, prevalencia y mortalidad de pacientes con mieloma múltiple, en un lapso de 10 años en Colombia. La prevalencia de la enfermedad es superior a la reportada por registros internacionales, según los RIPS, sin embargo, esto puede corresponder a un sobre registro, lo cual se estudiará en el segundo informe con mayor profundidad. La mayor prevalencia se confirmó en Bogotá y Antioquia y la mayor mortalidad se observó en la región del Orinoco.

4893 Background: The follicular lymphoma (FL) it is a subset of non-Hodgkin lymphomas, accounting for between 15% and 30% of new diagnoses of lymphoma. It has raised many combinations of treatments, but the long-term results remain unchanged. At present there is no consensus on the first line therapy for the management of follicular lymphoma. Since the advent of rituximab use, this change, achieving better response rates and survival, the paradigm is the use of R-CHEMO, but there are many active combinations, including the use CVP, CHOP, FCM, and others, which have shown benefit, but with consequences given for severe toxicity, and treatment-related deaths. In Colombia, the situation it is not different, the use of chemotherapy is left for consideration by the treating physician. This study aimed to assess treatment preferences for patients with new diagnosis of follicular lymphoma in Colombia, evaluate the responses of the combination R-CHEMOTHERAPY in our population, considering the specific ethnic characteristics and limitations of a developing country. Patients and Methods: The study included patients diagnosed with follicular lymphoma confirmed by hematopathologist with experience by performing at least 10 immunohistochemical tumor markers. This study is a descriptive study. During the study took into account the principles of autonomy, beneficence and justice written in the Belmont report. Informed consent was obtained from patients for participation in this study. It also welcomes the resolution expressed law Colombian Ministry of Health No. 008 430 1993 (4 October 1993) Article 11 investigation classified as safe. We analyzed cases diagnosed from January 2007 to July 2011 in two private institutions in the city of Bogotá, Colombia, we obtained 20 cases meeting the inclusion criteria. All the patients were scheduled to undergo primary therapy with 6 cycles of full-dose R-CVP or R-CHOP. Results: in this group, there were 5 men and 15 women (75% of all patients), and the median age at diagnosis was 56 years, the initial stage was 10% for stage II, 40% for stage III and the remaining 50% for stage IV, the bone marrow compromise reached by 45% (9 cases). The initial functional status classified by the ECOG scale was 0: 45%, 1: 50% and 3: 5%. the B symptoms were present in 95% of the patients analyzed. In accordance with the International Prognostic Index (FLIPI), we find the following: low risk: 25% (5 cases), intermediate risk: 35% (7 cases) and high risk: 40% (8 patients). the pathological grading was grade 1: 55% (11 patients), grade 2 for 35% (4 patients) and 3 for 10% (2 patients). When we reviewed found that the preferred treatment, for 80% of the population uses the R-CVP and the remaining 20% use of R-CHOP scheme, one patient in the R-CHOP group was complicated with high-risk febrile neutropenia requiring hospitalization. There were no treatment-related deaths. We found that 80% of patients achieved a complete hematologic remission and 20% partial response for an overall response of 100%. If we analyze separately patients treated with R-CVP scheme was 75% complete response and 25% partial response, with an overall response of 100%. Conclusion: This study shows the preference of treatment in 2 institutions in Bogotá, Colombia, which are in accordance with international guidelines, the results show a population with similar general characteristics with the others studies, in which a 100% overall hematologic response was achieved, 75% complete response for the R-CVP and 100% for the R-CHOP, however the latter with 25% of severe infectious complications. We consider a good treatment strategy for the implementation in our population is the R-CVP scheme, which is well tolerated, showing benefit in our patients and remission rates even higher than the studies previously published. Disclosures: No relevant conflicts of interest to declare.

Multiple myeloma (MM) is a heterogeneous and incurable disease considered the second most common hematologic malignancy globally. The incidence, prevalence, and mortality worldwide are well-known thanks to the data reported by the International Agency for Research on Cancer (IARC) and by the Global Cancer Observatory GLOBOCAN. Our objective was to estimate the incidence, prevalence, and mortality of MM in Colombia in this work. The total population diagnosed with multiple myeloma (ICD Code 10 C900) during the 2008-2018 period was used, which was included in the RIPS (Registro Individual de Prestación de Servicios) in Colombia.The standardized incidence and prevalence rates for Colombia in 2018 were 1.79 (CI 1.76-1.81) and 8.97 x 100,000 inhabitants/year (CI8.94-8.99), respectively. The age-standardized mortality rate for Colombia was 1.39 x 100,000 inhabitants (1.36-1.41) (adjusted with the population of the United States). The prevalence was higher than that reported by other sources and is comparable with those of the whole world, North America, and Spain. MM must be one of the cancers in which epidemiology must prioritize and organize health cancer care due to the ageing population.