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Introduction:In R/R DLBCL patients receiving CAR T-cell therapy (CAR-T), bridging therapy (BT) with chemotherapy, targeted therapy, and/or radiation therapy (RT) is often administered during the manufacturing window after collection and prior to CAR-T infusion to aid in tumor debulking and/or control symptomatic disease. However, little is known about the optimal type of BT and specifically, the impact BT may have on patterns of failure. Thus, we sought to compare the patterns of failure in patients who received CAR-T for R/R NHL at a single-institution based on the type of BT received. We hypothesize that bridging RT decreases the risk of local recurrence in sites treated with RT prior to CAR-T therapy.

Awan: MEI Pharma:Consultancy;Karyopharm:Consultancy;Genentech:Consultancy;Astrazeneca:Consultancy;Abbvie:Consultancy;Janssen:Consultancy;Pharmacyclics:Consultancy;Sunesis:Consultancy;Gilead Sciences:Consultancy;Kite Pharma:Consultancy;Dava Oncology:Consultancy;Celgene:Consultancy;Blueprint medicines:Consultancy.Desai:Boston Scientific:Consultancy, Other: Trial Finding.

No relevant conflicts of interest to declare.

Coordinated interaction of many cell types is required to facilitate hematopoietic and mesenchymal stem cell maintenance and differentiation in the bone marrow. However, the molecular factors and cell types involved in this complex interplay remain poorly understood. Here we developed a combined single cell and spatial transcriptomics approach to address this problem.

No relevant conflicts of interest to declare.

Recent reports have highlighted the importance of platelets as inflammatory and immune cells in addition to their well-known function in thrombosis. Systemic inflammation associated with acute infection triggers the release of immune-modulatory agents and the interaction of platelets with neutrophils to facilitate the formation of neutrophil extracellular traps (NETs). This provokes a rapid consumption of platelets resulting in a transient thrombocytopenia. During acute inflammation, low platelet levels are associated with a loss of vascular integrity and hemorrhage, as well as septic shock resulting in increased mortality. Therefore, a fast recovery of platelet levels is essential. However, the exact mechanism by which platelet levels are rapidly regenerated after acute inflammation remains unknown.

No relevant conflicts of interest to declare.

Introduction. The risk of developing a second primary cancer (SPC) is increased in patients with CLL. The mechanisms explaining this association could be related to lifestyle, environment, host factors or interactions or other influences. We conducted an epidemiological study based on 10 French registries and evaluated the risk of developing SPC in patients with CLL.

Despite recent progresses in treatment, invasive aspergillosis (IA) is still associated with high treatment failure and elevated death rates. Prognostic factors have not yet been identified in a large population of oncohematological patients (pts) developing IA. We reviewed all cases of possible, probable or definite IA according to the EORTC/MSG criteria occurring in adult oncohematological pts since January 1997. Two hundred and ninety nine pts received at least one dose of anti-aspergillus therapy and were analyzed for prognosis factors. Demographic, clinical, radiological, biological and mycological variables available at time of start of antifungal therapy were analyzed for their effects on 3-month specific survival (pts dying of another cause were censored at time of death) and 3-month overall survival. All variables with a p-value less than 0.2 in univariate analysis were introduced into a multivariate Cox regression model, allowing for interactions. The analysis was stratified by the type of first line therapy to produce a consistent analysis of the other variables. Underlying condition included allogeneic hematopoietic stem cell transplantation (HSCT) (n=41), autologous HSCT (n=24), solid organ transplantation (SOT) (n=10), acute leukemia (n=91), other hematological malignancy (n=67), solid tumor (n=35) or non-malignant disease (n=21). Infection was localized to the lung in 258 pts, to another single organ, mostly sinuses, in 12 pts and was disseminated in 19 cases. Overall and specific survival rates at 3 months were 52.3% (95% CI: 46.5–57.9%) and 59.5% (95% CI: 53.6–65.0%) respectively. Prognostic factors for 3-month overall survival are shown in table 1. Prognosis factors for 3-month specific survival were the same, with the following exceptions: monocyte count was no more significant (p=0.57), baseline neutrophil count (< vs. ≥ 500 μ L) and radiological aspects (single vs. multiple vs. diffuse lesions) became significant with p-values at 0.003 and 0.048 respectively. Our study identified several risk factors for death in oncohematological pts with IA. These factors should help to early identify pts who would benefit from more aggressive antifungal therapeutic strategies. Table 1. Three-month overall survival after stratification on treatment Predictor Reference category Hazard ratio 95% CI p-value Host factor AlloHSCT or SOT Hematological malignancy 1.78 1.12–2.84 0.0391 Other 1.52 0.86–2.68 Progression of underlying disease No 4.54 2.68–7.67 <0.001 Prior non-infectious respiratory disease Absence 1.76 1.18–2.62 0.006 Steroids dose ≥ 0.2 mg/kg <0.2 mg/kg 2.33 1.50–3.63 <0.001 Creatinine clearance 30–59 mL/min ≥ 60 mL/min 1.65 1.06–2.55 <0.001 <30 mL/min 2.51 1.56–4.03 Monocytes >100/μ L ≤ 100/μ L 0.59 0.41–0.85 0.004 Site of infection Disseminated Lung only 3.20 1.72–5.93 0.001 Other single organ NA NA Pleural effusion Absence 1.77 1.19–2.63 0.005 Possible IA Probable or definite 0.51 0.34–0.780.002

Despite recent progresses in treatment, invasive aspergillosis (IA) is still associated with high treatment failure and elevated death rates. Prognostic factors have not yet been identified in a large population of oncohematological patients (pts) developing IA. We reviewed all cases of possible, probable or definite IA according to the EORTC/MSG criteria occurring in adult oncohematological pts since January 1997. Two hundred and ninety nine pts received at least one dose of anti-aspergillus therapy and were analyzed for prognosis factors. Demographic, clinical, radiological, biological and mycological variables available at time of start of antifungal therapy were analyzed for their effects on 3-month specific survival (pts dying of another cause were censored at time of death) and 3-month overall survival. All variables with a p-value less than 0.2 in univariate analysis were introduced into a multivariate Cox regression model, allowing for interactions. The analysis was stratified by the type of first line therapy to produce a consistent analysis of the other variables. Underlying condition included allogeneic hematopoietic stem cell transplantation (HSCT) (n=41), autologous HSCT (n=24), solid organ transplantation (SOT) (n=10), acute leukemia (n=91), other hematological malignancy (n=67), solid tumor (n=35) or non-malignant disease (n=21). Infection was localized to the lung in 258 pts, to another single organ, mostly sinuses, in 12 pts and was disseminated in 19 cases. Overall and specific survival rates at 3 months were 52.3% (95% CI: 46.5–57.9%) and 59.5% (95% CI: 53.6–65.0%) respectively. Prognostic factors for 3-month overall survival are shown in table 1. Prognosis factors for 3-month specific survival were the same, with the following exceptions: monocyte count was no more significant (p=0.57), baseline neutrophil count (< vs. ≥ 500 μ L) and radiological aspects (single vs. multiple vs. diffuse lesions) became significant with p-values at 0.003 and 0.048 respectively. Our study identified several risk factors for death in oncohematological pts with IA. These factors should help to early identify pts who would benefit from more aggressive antifungal therapeutic strategies.