Abstract 276P
Background
Lymphadenpathy is a very unusual manifestation of CML-CP with an unclear implication on prognosis. We sought to understand the occurrence of this phenomenon and its effect on prognosis in newly diagnosed cases of CML-CP at a tertiary cancer centre in South India.
Methods
A retrospective analysis of all the newly diagnosed cases of CML-CP between January 2016 and December 2018 was undertaken and patients presenting with lymphadenopathy were identified. Data pertaining to CML diagnosis, work up and their clinical outcomes were recorded. Descriptive statistics were used.
Results
Four cases of CML-CP presenting with lymphadenopathy were identified out of 143 cases recorded in this time period (2.8%). The age range is 7-44 years (mean = 25 years) for these cases. All these cases were diagnosed on basis of peripheral smear and bone marrow picture consistent with CML-CP and RT-PCR for BCR-ABL positive for e13a2 (p210). Lymphadenopathy was cervical alone in one case and generalized in the rest of the cases. FNAC of lymph nodes at baseline were suggestive of reactive lymphadenitis. Two out of 4 patients (50%) were high risk according to EUTOS score. All the patients (irrespective of risk group) were started on Imatinib 400mg qDay (250mg/m2 for the paediatric patient). All the four patients progressed to blast crisis, 3 of them being lymphoid blast crisis (75%). The mean time to progression was 14.5 months (range 6-23 months). In contrast, only 1 patient in the rest of 139 patient cohort developed blast crisis in the three years data. ABL kinase domain mutation analysis was done in all the four patients, 2 of them showed Imatinib resistant mutations with both of them more sensitive to Dasatinib. Karyotype at the time of progression to blast crisis was done in 2 patients and it showed isochromosome 17p in one patient.Table1: 276P
Clinical features and key investigation of patients of CML-CP presenting with lymphadenopathy
Age/sex | EUTOS risk | time to progression (months) | ABL KD mutation | Karyotype |
---|---|---|---|---|
7/F | High | 6 | not detected | Iso17p |
18/M | Low | 12 | Not detected | Not done |
32/M | Low | 14 | M244V | Not done |
44/M | High | 23 | Y235H | Normal |
Conclusions
Lymphadenopathy at diagnosis of CML-CP has a very poor prognosis and heralds early progression to blast crisis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Gedala Veni Prasanna.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
220P - An outcome analysis of robotassisted radical nephroureterectomy with extended template lymphadenectomy for upper tract urothelial carcinoma
Presenter: Ashwin Tamhankar
Session: Poster display session
Resources:
Abstract
221P - Comparative analysis of first-line immune checkpoint inhibitor versus carboplatin-based chemotherapy for cisplatin-ineligible metastatic urothelial carcinoma: A multicenter, retrospective real-world evidence
Presenter: Hsiang‐Lan Lai
Session: Poster display session
Resources:
Abstract
222P - Does tumor grade really improve the prognostic ability of the staging system for men with penile cancer: A SEER database analysis
Presenter: Ravi Kanodia
Session: Poster display session
Resources:
Abstract
223TiP - EV-301: A phase III trial in progress evaluating enfortumab vedotin versus chemotherapy in patients with locally advanced or metastatic urothelial carcinoma
Presenter: Daniel Petrylak
Session: Poster display session
Resources:
Abstract
230P - Olaparib maintenance therapy in patients (pts) with a BRCA1 and/or BRCA2 mutation (BRCAm) and newly diagnosed advanced ovarian cancer (OC): SOLO1 China cohort
Presenter: Lingying Wu
Session: Poster display session
Resources:
Abstract
231P - Cost-effectiveness of olaparib vs routine surveillance in the maintenance setting for patients with BRCA-mutated advanced ovarian cancer after response to first-line platinum-based chemotherapy in Singapore
Presenter: David SP Tan
Session: Poster display session
Resources:
Abstract
233P - Incorporation of correlative studies in ovarian cancers in the era of precision medicine: Assessment of accountability and utility
Presenter: Nadia Hitchen
Session: Poster display session
Resources:
Abstract
234P - Implementation of mainstream BRCA testing in epithelial ovarian cancer in a tertiary centre
Presenter: Edbert Wong
Session: Poster display session
Resources:
Abstract
235P - The efficacy of radiation therapy in ovarian carcinoma: A propensity score analysis of a population-based study
Presenter: Jian-Guo Zhou
Session: Poster display session
Resources:
Abstract
236P - Front-line maintenance therapy for platinum-sensitive ovarian cancer: What’s next PARP inhibitors?
Presenter: Han Gong
Session: Poster display session
Resources:
Abstract