Biofeedback as single first-line treatment for non-neuropathic dysfunctional voiding in children with diurnal enuresis

Introduction: Non-neurogenic dysfunctional voiding (NDV) accounts for a significant portion of pediatric urology outpatient clinic visits. Biofeedback (BF) is a promising, non-invasive modality for treating children with DV and daytime wetting. Our objective was to investigate BF’s efficacy as a single first-line treatment for children with NDV and diurnal enuresis. Methods: A retrospective cohort study was conducted with a total of 61 consecutive patient records from January 2009 to March 2016. All children with NDV who had BF as first-line treatment were included. Full urological histories, physical examinations, dysfunctional voiding symptom score (DVSS), urine analysis, ultrasound (US), and uroflowmetry (UFM), and electromyogram (EMG) were performed and recorded for all patients before and after finishing the last BF cycle. The patient’s satisfaction scale was also obtained. Results: The mean age was 10±2.6 years. Most patients (80.3%) were females. The presenting symptoms were diurnal enuresis, urinary tract infections, and voiding discomfort in 52 (85.2%), 16 (26.2%), and 38 (62.3%) patients, respectively. Six months after the last BF cycle, there was a statistically significant objective improvement in US and UFM+EMG findings, with the disappearance of EMG signals in 40 of 61 (65.5%) patients. There was also a significant subjective symptomatic improvement, as the mean DVSS had decreased from 14 to 7.9 (p=0.003). Forty-seven patients (77%) were satisfied, while only eight (13.1%) were not. Conclusions: BF is considered a potentially effective, single firstline treatment modality for children with DV and diurnal enuresis. Long-term outcome assessments are needed to assess the children’s compliance and symptom recurrence.

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PS01.095: BENIGN ESOPHAGEAL STRICTURE: A RECAP OF OUR EXPERIENCE

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.095 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 76-76

Author(s):

Keat How Teoh ◽

Kelvin Voon ◽

Shyang Yee Lim ◽

Premnath Nagalingam

Keyword(s):

Endoscopic Treatment ◽

Esophageal Stricture ◽

Endoscopic Dilatation ◽

Line Treatment ◽

First Line ◽

Benign Esophageal Stricture ◽

Anastomotic Strictures ◽

Esophageal Strictures ◽

The Mean ◽

First Line Treatment

Abstract Background Caustic injury remains the commonest cause of benign esophageal strictures in Asia. Others include gastroesophageal reflux, iatrogenic, radiation, autoimmune or idiopathic causes. Treatment goals are relief of dysphagia and prevention of recurrence. This study aims to evaluate the experience with benign esophageal stricture in Penang Hospital, a tertiary hospital in Northern region of Malaysia. Methods A retrospective review of 12 patients with benign esophageal strictures between year 2012 - 2017. Results The mean age was 53.5 and two thirds were female. Half of these patients were of Chinese ethnicity while the other half were Indian. The commonest cause was caustic ingestion (41.7%), followed by reflux stricture (25%) and anastomotic stricture (25%). There was one case of dystrophic epidermolysis bullosa. More than half of the patients had complex and multiple strictures. 41.7% of patients had proximal strictures that were located within 20cm from the incisors. Endoscopic dilatation was the first line treatment with either Savary Gilliard or balloon dilators. A total of 97 dilatation sessions were done with a mean dilatation frequency of 2.3 ± 1.5 times for anastomotic strictures, 8 ± 8.2 times for reflux strictures and 8.0 ± 6.6 times for corrosive strictures. The mean dilatation interval was 2.5 ± 1.2 weeks. 58.3% of patients had successful endoscopic treatment. The success rate was higher in non-corrosive stricture (83% vs 40%). There was one dilatation related complication in which the patient had pneumomediastinum without overt mediastinitis. This however, resolved with conservative management. 41.7% of patients had refractory strictures that failed endoscopic dilatation. Surgery including esophagectomy (40%), revision of anastomosis (20%) and gastrostomy (40%) were done for this group of patients. Proximal strictures, complex strictures and multiple strictures were associated with failed endoscopic dilatation (P < 0.05). Conclusion Endoscopic dilatation is the first line treatment for benign esophageal strictures. Surgery is reserved for refractory strictures with failed endoscopic treatment. Predictor scoring systems for refractory stricture and individualized approaches are the key to success. Disclosure All authors have declared no conflicts of interest.

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Can endovascular repair be the first-line treatment option in abdominal aortic aneurysms during COVID-19 pandemic?

Turkish Journal of Vascular Surgery ◽

10.9739/tjvs.2021.968 ◽

2021 ◽

Vol 30 (2) ◽

pp. 107-114

Author(s):

Kaptanıderya Tayfur ◽

Melih Ürkmez

Keyword(s):

Treatment Option ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Line Treatment ◽

Rt Pcr ◽

First Line ◽

Abdominal Aortic ◽

Significant Difference ◽

The Mean ◽

First Line Treatment

Objectives: This study aims to investigate the effectiveness of endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) during the novel coronavirus-2019 (COVID-19) pandemic. Patients and methods: A total of 22 patients (17 males, 5 females; mean age: 76.7±7.1 years; range, 66 to 90 years) who underwent EVAR for AAAs in our center between March 2020 and December 2020 were retrospectively analyzed. All patients underwent reverse transcriptase- polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection. All EVAR procedures were performed under spinal anesthesia in the elective setting in the angiography laboratory. Results: The RT-PCR test result was positive in six patients with asymptomatic infection. The mean AAA diameter was 74.7±5.5 (range, 68.50 to 85.60) mm. Stent-graft implantation was successfully performed in all patients. There was no significant relationship between the mean age and examined variables (p>0.050). The mean AAA diameter was 83.95 mm in the COVID-19-positive patients and 71.50 mm in the COVID-19-negative patients, indicating a significant difference (p=0.001). No mortality, stent migration or thrombotic events were observed during the first 30 days of follow-up. Conclusion: The operation can be delayed in patients requiring open surgical repair or in those with small AAAs. Based on our findings, the EVAR can be used as the first-line treatment option during the pandemic, as it does not require intubation and requires a low number of staff and is cost-effective with minimum necessity for intensive care unit stay and less use of healthcare resources.

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Outcome of Injection Botulinum Toxin in Blepharospasm

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i1.30589 ◽

2021 ◽

Vol 13 (1) ◽

pp. 40-49

Author(s):

Malita Amatya ◽

Ben Limbu ◽

Purnima Rajkarnikar ◽

Hom Bahadur Gurung ◽

Rohit Saiju

Keyword(s):

Botulinum Toxin ◽

Hemifacial Spasm ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

Line Treatment ◽

First Line ◽

Essential Blepharospasm ◽

Meige Syndrome ◽

The Mean ◽

First Line Treatment

Introduction: Blepharospasm is a condition of involuntary spasm of the orbicularis oculi muscle which leads to intermittent or complete closure of the eyelids. Botulinum toxin is the currently recommended first line treatment for such blepharospasm. This study aims to find out the outcome of injection Botulinum toxin Type A in Blepharospasm. Materials and methods: It was a hospital based, prospective, interventional study conducted on patients diagnosed as Benign essential blepharospasm (BEB), Meige syndrome (MS) and Hemifacial spasm (HFS) by oculoplastic surgeon at Oculoplasty department OPD, Tilganga Institute of Ophthalmology, from December 2018 to November 2019. After taking all standard precautions for botulinum toxin injections, 6 to 8 sites for injecting 2.5 to 5 IU of the toxin were given. All the patients were evaluated before and after injections according to Jankovic spasm grading and improvement in functional impairment scale and followed on one week, one month, three month and when the symptoms reappeared. Results: A total of 43 cases which included 32 cases of Benign essential Blepharospasm, 9 Hemifacial spasm and 2 Meige syndrome. The mean Jankovic severity score was 3.51 ± 0.51 (range 3-4). The mean improvement in functional score was 2.60 ± 0.54 (range 1-3), was statistically significant (p-value <0.001).The effective period of injection was 130 ± 20.82 (93 – 189) days.38 patients had repeated injections after reappearance of symptoms. 4 patients had side effects of redness and hematoma at one site. Conclusion: This study concludes that Botulinum toxin type A is effective in the management of Benign essential blepharospasm, Hemifacial spasm and Meige syndrome. This along with a good safety profile justifies its role as a first line treatment therapy in blepharospasm. However, it is a temporary treatment option where the effect lasts for a short period of time and repeated injections are required.

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Efficacy of balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children

The Journal of Laryngology & Otology ◽

10.1017/s0022215120002340 ◽

2020 ◽

pp. 1-4

Author(s):

B Demir ◽

C Batman

Keyword(s):

Otitis Media ◽

Otitis Media With Effusion ◽

Line Treatment ◽

Ventilation Tube ◽

First Line ◽

Tube Insertion ◽

The Mean ◽

Group 2 ◽

Balloon Eustachian Tuboplasty ◽

First Line Treatment

Abstract Objective This study aimed to compare the outcomes of ventilation tube insertion and balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children. Method This was a retrospective evaluation of 62 children, 30 cases that underwent balloon Eustachian tuboplasty (group 1) and 32 cases that underwent ventilation tube insertion (group 2), from July 2016 to April 2018. Results The pre-operative air–bone gap of patients who underwent balloon Eustachian tuboplasty was 15–35 dB (mean: 27.6 ± 8.2 dB). The mean pre-operative air–bone gap decreased to 9.6 dB after a mean of 14.4 months (p < 0.05). The air–bone gap decreased from 25.6 dB to 17.6 dB in the ventilation tube group. There was a significant improvement in the air–bone gap values in both groups; however, this decrease was significantly higher in the balloon Eustachian tuboplasty group (p = 0.043). Conclusion Balloon Eustachian tuboplasty may be an effective and safe method for use as a first-line treatment of otitis media with effusion in children.

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Long-term outcome of a phase 2 trial with nilotinib 400 mg twice daily in first-line treatment of chronic myeloid leukemia

Haematologica ◽

10.3324/haematol.2015.129221 ◽

2015 ◽

Vol 100 (9) ◽

pp. 1146-1150 ◽

Cited By ~ 27

Author(s):

G. Gugliotta ◽

F. Castagnetti ◽

M. Breccia ◽

L. Levato ◽

M. D'Adda ◽

...

Keyword(s):

Chronic Myeloid Leukemia ◽

Myeloid Leukemia ◽

Line Treatment ◽

Phase 2 ◽

First Line ◽

Term Outcome ◽

Long Term Outcome ◽

Phase 2 Trial ◽

First Line Treatment

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DTIC and GM-CSF in the treatment of patients with metastatic melanoma.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e19045 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e19045-e19045

Author(s):

Beth Barber ◽

Zhongyun Zhao ◽

Song Wang ◽

Volker Jean Wagner

Keyword(s):

Metastatic Melanoma ◽

Charlson Comorbidity Index ◽

Treatment Duration ◽

Line Treatment ◽

First Line ◽

Gm Csf ◽

Comorbidity Index ◽

The Mean ◽

First Line Treatment

e19045 Background: To describe patients with metastatic melanoma being treated with mono-therapy, dacarbazine (DTIC) or granulocyte-macrophage colony-stimulating factor (GM-CSF). Methods: Using a large U.S. medical claims database, patients were identified between 2005 and 2010 using ≥2 melanoma diagnoses (ICD-9-CM: 172.xx, V10.82) and ≥2 diagnoses for metastasis (ICD-9-CM: 197.xx, 198.xx). Patients who received mono-therapy with DTIC or GM-CSF as the first documented drug therapy after metastatic diagnosis were identified. Patient demographic and clinical characteristics and treatment duration were compared between patients treated with DTIC and those who received GM-CSF. Furthermore, comparisons were also made between the two treatment groups after 1-to-1 matching on age, gender, and baseline comorbidities. Results: A total of 81 patients with metastatic melanoma receiving first-line DTIC and 24 patients with metastatic melanoma receiving first-line GM-CSF were included in this analysis. On average, DTIC patients were 8.5 years older (p = 0.009) and had higher baseline Charlson Comorbidity Index scores (D0.43, p = 0.005) than GM-CSF patients. The mean duration of first line treatment was 94 days on DTIC and 135 days on GM-CSF. The mean length of follow-up from the start of first line was 257 days on DTIC and 451 days on GM-CSF. After each GM-CSF patient was matched with a DTIC patient on age, gender, and baseline Charlson Comorbidity Index score, the mean duration of first line treatment was 79 days on matched DTIC and 135 days on GM-CSF, and the mean length of follow-up from the start of first line was 317 days on matched DTIC and 451 days on GM-CSF. Conclusions: Patients with metastatic melanoma who received DTIC treatment were older and had higher comorbidity index scores but shorter treatment duration than those who received GM-CSF; the difference in treatment duration remained after DTIC patients were matched with GM-CSF patients on age, gender and comorbidity index scores.

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Intra-Arterial Catheter Guided Steroid Administration For The Treatment Of Steroid-Refractory Intestinal GvHD

Blood ◽

10.1182/blood.v122.21.4604.4604 ◽

2013 ◽

Vol 122 (21) ◽

pp. 4604-4604

Author(s):

Michael Medinger ◽

David Buergler ◽

Jakob Passweg ◽

Arne Fischmann ◽

Christoph Bucher

Keyword(s):

Median Time ◽

Adult Patients ◽

Line Treatment ◽

Second Line ◽

First Line ◽

Steroid Administration ◽

The Mean ◽

Grade Iii ◽

First Line Treatment ◽

Steroid Refractory

Background Acute gastrointestinal GvHD (GI-aGvHD) refractory to first line treatment with systemic corticosteroids is resulting in death in the majority of patients. Intra-arterial local dose intensification in the gut has been reported in pediatric but not in adult patients. We prospectively assessed the feasibility and efficacy of regional intra-arterial steroid treatment in adult patients with severe (>= grade III) GI-aGvHD not responding to first line treatment. Patients and Methods Patients with more than +++ GI-aGvHD not responding to intravenous methylprednisolone at a dose of 2 mg/kg/day within 14 days were eligible for inclusion. Catheter guided intra-arterial steroid administration (IASA) was performed by accessing the right or left common femoral artery; a 4 Fr angiography catheter was used to locate and select the superior and inferior mesenteric artery and, in patients with upper gastrointestinal symptoms into the celiac trunk (9 patients) and the left gastric artery (2 patients). The mean total dose of methylprednisolone administered over 1 minute was 180 mg (120-240 mg). In 7 patients with persistent or recurring symptoms, IASA was repeated within 14 days. Response assessment was at 28 days after IASA. CR was defined as complete resolution of GI symptoms; partial response was defined as reduction of GI score from +++ to ++. Non-response was defined as the same grade of aGvHD, progression of symptoms or death within 28 days after IASA. Results Between January 2010 and June 2012, 12 consecutive patients with steroid-refractory GI-aGvHD received IASA as second line treatment. The patient's baseline characteristics are summarized in Table 1. The mean patient's age was 53 years (range 30 - 69), 9 were male and 3 female. All patients received peripheral blood stem cells as stem cell source. All 12 patients had grade III GI-aGvHD. At time of initial IASA, 4 patients had skin (grade + - +++) and 2 patients had liver (grade +) involvement. In all patients the overall grade of aGvHD was III. The median time from HSCT to onset of GI-aGvHD was 20 days (range 6 - 278). The median time from onset of GI-aGvHD to initial IASA was 19 days (range 9 - 41). 7 patients not responding to the first IASA received a second IASA (median period of time between IASA was 13 days, range 6 - 14). 83% of patients had gastrointestinal response including four patients (33%) with complete response at 28 days after IASA (Table 2). 6/12 patients were alive at a median time of 531 days (389 – 1362) after IASA. During IASA no technical complications occurred. There was one duodenal ulcer in one patient two days after second IASA that resolved after treatment. Conclusion Regional treatment of severe GVHD with IASA treatment seems to be a safe and effective second line treatment for steroid-refractory GI-aGvHD in adult patients. Our results compare favorably with reported results of steroid-refractory GI-aGvHD. Disclosures: No relevant conflicts of interest to declare.

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Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated Patients

Gastroenterology Research and Practice ◽

10.1155/2021/9237617 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Johannes Manzeneder ◽

Christoph Römmele ◽

Carolin Manzeneder ◽

Alanna Ebigbo ◽

Helmut Messmann ◽

...

Keyword(s):

Adverse Events ◽

Endoscopic Treatment ◽

Symptom Relief ◽

Zenker’S Diverticulum ◽

Line Treatment ◽

First Line ◽

Zenker's Diverticulum ◽

Treatment Naïve ◽

The Mean ◽

First Line Treatment

Background and Aims. Flexible endoscopic treatment plays an important role in the treatment of Zenker’s diverticulum (ZD). This study analyzes long-term symptom control and the rate of adverse events in treatment-naïve patients and patients with recurrence, using the stag beetle knife junior (sb knife jr). Methods. From August 2013 to May 2019, 100 patients with symptomatic ZD were treated with flexible endoscopy using the sb knife jr. Before treatment, as well as 1 and 6 months afterwards, symptoms were obtained by a nine-point questionnaire, with symptoms weighted from 0 to 4. Results. Overall, 126 interventions were performed. The median follow-up period was 41 months (range 7-74). For the three most frequent symptoms, regurgitation, dysphagia, and dry cough, a significant reduction of the mean score could be achieved, from 2.85/3.45/2.85 before the initial treatment to 0.56/1.09/0.98 6 months later. 17 patients were retreated because of recurrence. Out of these, 12 patients underwent a 2nd, 4 patients a 3rd, and 1 patient a 4th session, respectively. The mean dysphagia score for successfully treated patients could be reduced from initially 2.34 to 0.49/0.33/0.67 after the 1st/2nd/3rd session, the frequency of dysphagia from 3.45 to 0.92/1.00/1.33, and the score for regurgitations from 2.85 to 0.35/1.00/0.67. In first-line treatment, as well as in retreatment, no severe adverse event occurred. Conclusion. Patients with ZD can be treated safely and effectively with the sb knife jr. Retreatment leads to equal symptom relief as compared to a successful first-line treatment and is not associated with a higher rate of adverse events.

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Peripheral Immune Cell Ratios and Clinical Outcomes in Seropositive Autoimmune Encephalitis: A Study by the Australian Autoimmune Encephalitis Consortium

Frontiers in Immunology ◽

10.3389/fimmu.2020.597858 ◽

2021 ◽

Vol 11 ◽

Cited By ~ 1

Author(s):

James Broadley ◽

Robb Wesselingh ◽

Udaya Seneviratne ◽

Chris Kyndt ◽

Paul Beech ◽

...

Keyword(s):

Hospital Admission ◽

Autoimmune Encephalitis ◽

Clinical Relapse ◽

Line Treatment ◽

First Line ◽

Long Term Outcome ◽

Lymphocyte Ratio ◽

Initial Hospital ◽

First Line Treatment

ObjectiveTo examine the utility of the peripheral blood neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) as biomarkers of prognosis in seropositive autoimmune encephalitis (AE).MethodsIn this multicenter study, we retrospectively analyzed 57 cases of seropositive AE with hospital admissions between January 2008 and June 2019. The initial full blood examination was used to determine each patients’ NLR and MLR. The modified Rankin Scale (mRS) was utilized to assess the patients’ follow-up disability at 12 months and then at final follow-up. Primary outcomes were mortality and mRS, while secondary outcomes were failure of first line treatment, ICU admission, and clinical relapse. Univariate and multivariable regression analysis was performed.ResultsDuring initial hospital admission 44.7% of patients had unsuccessful first line treatment. After a median follow-up of 700 days, 82.7% had good functional outcome (mRS ≤2) while five patients had died. On multivariable analysis, high NLR was associated with higher odds of first line treatment failure (OR 1.32, 95% CI 1.03–1.69, p = 0.029). Increased MLR was not associated with any short or long-term outcome.ConclusionsNLR on initial hospital admission blood tests may be provide important prognostic information for cases of seropositive AE. This study demonstrates the potential use of NLR as a prognostic marker in the clinical evaluation of patients with seropositive AE.

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Prognostic Factors and Long Term Outcome of 138 Adults with Systemic Anaplastic Large-Cell Lymphoma: a Retrospective Study by the Groupe d'Etude Des Lymphomes De l'Adulte (GELA)

Blood ◽

10.1182/blood.v116.21.322.322 ◽

2010 ◽

Vol 116 (21) ◽

pp. 322-322 ◽

Cited By ~ 4

Author(s):

David Sibon ◽

Marion Fournier ◽

Josette Briere ◽

Laurence Lamant ◽

Corinne Haioun ◽

...

Keyword(s):

Cell Lymphoma ◽

Large Cell ◽

Line Treatment ◽

First Line ◽

Term Outcome ◽

Long Term Outcome ◽

Entire Cohort ◽

Large Cell Lymphoma ◽

First Line Treatment

Abstract Abstract 322 Background: anaplastic large-cell lymphoma (ALCL) is a T-cell lymphoma characterized by peculiar morphologic features and strong expression of CD30. Based on the anaplastic lymphoma kinase (ALK) protein expression, the current WHO classification distinguishes ALK+ and ALK- systemic ALCL as separate disease entities. ALK+ ALCL has classically a better prognosis than ALK- ALCL, however the independant prognostic value of ALK expression remains debated and the long term outcome of adults with systemic ALCL is not known. Patients and Method: eligibility criteria for this study included patients with confirmed diagnosis of systemic ALCL after immunohistopathological review and defined ALK expression status. Patients were retrieved from the GELA LNH87-LNH93-LNH98 prospective clinical trials. Most patients received an anthracyline-based regimen as first line treatment. Result: of the 138 included patients with systemic ALCL, 64 (46%) were ALK+ and 74 (54%) were ALK-. The median follow-up duration was 8 years. At diagnosis patients with ALK+ ALCL were younger than those with ALK- ALCL (median age 31 vs 56 years) with significantly more patients < 40 years in ALK+ group (66% vs 23%, p<0.0001). There was a predominance of males in both types (64%). The performance status (PS) was poor (≥2) in 16% (ALK+) vs 33% (ALK-) (p=0.019). The IPI score was high (3-5) in 24% (ALK+) vs 48% (ALK-) (p=0.03). Beta2microglobulin (level available in 90/138 patients) was ≥ 3 mg/L in 12% (ALK+) vs 33% (ALK-) (p=0.016). Ann Arbor stage, elevated LDH, number of extranodal sites > 1, bulky disease (mass > 10 cm), B symptoms, blood cell counts, hypoalbuminemia < 35 g/L and gammaglobulin level had a similar distribution in ALK+ and ALK- patients. The overall response rate to first line treatment was better in ALK+ than in ALK- patients (89% vs 76%, p=0.0417). Eleven patients died during first line treatment, all in the ALK- group. All these patients had disseminated disease. Fourteen (22%) patients relapsed in ALK+ group vs 26 (35%) patients in ALK- group. After 3 years, there was no relapse in ALK+ group, whereas 3/26 relapses in ALK- group (2 relapses after 5 years). The 8-year progression-free survival (PFS) was 54% (95% CI 45–63%) for the entire cohort, 72% (95% CI 58–83%) in ALK+ vs 39% (95% CI 27–51%) in ALK- patients (p=0.0005), and 8-year overall survival (OS) was 64% (95% CI 55–72%) for the entire cohort, 82% (95% CI 69–89%) in ALK+ vs 49% (95% CI 37–61%) (p<0.0001). Clinical and laboratory features were tested in univariate analysis for their impact on PFS and OS in the whole cohort and in ALK+ and ALK- groups. IPI (and its 5 factors taken individually), age < 40 years, ALK status, mediastinal, lung, liver and spleen involvement, hypoalbuminemia < 35 g/L and beta2microglobulin ≥ 3 mg/L had a significant impact on PFS and OS. Interestingly, in patients < 40 years old, there was no impact of ALK status on PFS/OS. In multivariate analysis taking into account factors of IPI (with a cut-off at 40 years for age) and ALK status, only number of extranodal sites, age and ALK status remained significant predictors of PFS and OS. Adding beta2microglobulin to these 6 factors resulted in a model in which only beta2microglobulin (p= 0.0003 for PFS and p=0.0004 for OS) and age (p= 0.04 for PFS and p=0.03 for OS) had a significant impact on PFS and OS, beta2microglobulin being the most discriminant factor (Figure). Not all the ALK- ALCL had a poor prognosis, and reciprocally not all the ALK+ ALCL had a favorable outcome. Conclusion: this long term study of ALCL emphasizes the prominent impact of age and beta2microglobulin both in ALK+ and ALK- ALCL in PFS and OS. These two factors could be useful for improving the prognostic assessment of patients with ALCL. They could also be of help in stratifying patients in prospective trials. Disclosures: No relevant conflicts of interest to declare.

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