19 th Congress of the European Hematology Association standard chemotherapy protocols. Planar and SPECT images were carried Aggressive Non-Hodgkin lymphoma - Clinical out 30 minutes and 3 hours after intravenous injection of 740 MBq 99m Tc- Tetrofosmin and analyzed qualitatively and quantitatively. The scintigraphic results were compared with the data of conventional methods (clinical PB1813 examination, x-ray, CT). Additionally, patients underwent 18F-FDG PET-CT scan. Beta-2-microglobulin was measured by radioimmunoassay. THE ROLE OF HIGH DOSE CHEMOTHERAPY FOLLOWED BY Results: 99mTc-Tetrofosmin scintigraphy was positive in 42 patients with HL AUTOLOGOUS STEM CELL TRANSPLANTATION AS FIRST LINE and NHL before treatment. From 58 detected lesions 40 had lymph node TREATMENT IN PATIENTS WITH AGGRESSIVE NON-HODGKIN involvement. Increased uptake of the radiotracer was demonstrated in LYMPHOMA: A SYSTEMATIC REVIEW AND META-ANALYSIS mediastinal, neck, supraclavicular, axillar and inguinal lymph nodes. Extranodal D Dahan-Shriki 1, A Gafter-Gvili 1,2, L Vidal 1,2, P Raanani 1,2, O Shpilberg 2, localization was detected in 18 lesions. The tumour/background ratio ranged R Gurion 1,2, * from 1.5 to 2.1. In six patients with false negative scintigraphy, CT investigation 1Institute of Hematology, Rabin Medical Center, Petah Tikva, 2Tel Aviv University, Tel Aviv, Israel showed enlarged abdominal lymph nodes. True negative 99mTc-Tetrofosmin scan after chemotherapy was registered in 37 patients. Focal pathological tetrofosmin uptake was seen in ten patients and 21 lesions were identified. Background: Rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) has been the mainstay of treatment in patients with Fourteen lymph node lesions were detected in mediastinal, neck, aggressive non-Hodgkin lymphoma (NHL). Despite the improvement in survival supraclavicular, axillar and inguinal area. Seven lesions had extranodal rate with the addition of rituximab, there are still a significant proportion of localization – lungs and bones. False negative scintigraphy was found in 8 patients, whereas CT scan showed lesion with subdiaphragmatic localization. patients who cannot be cured with conventional therapy . One of the strategies to improve survival rate is consolidation treatment with high dose chemotherapy The presence of B-symptoms and elevated beta-2-microglobulin were found (HDT) followed by autologous stem cell transplantation (ASCT), especially in in these patients. The patients with inconclusive 99mTc-Tetrofosmin scan were young patients with high risk aggressive NHL. Randomized controlled trials referred to PET-CT. Additional 22 PET-CT positive nodal and extranodal that addressed this issue yielded conflicting results. subdiaphragmatic lesions were detected. 99mTc-Tetrofosmin is a promising tracer in Aims: In order to examine the effect of HDT and ACST on overall survival, we Summary and Conclusions: performed a systematic review and meta-analysis. determining disease activity in supradiaphragmatic lesions. This method that has high sensitivity and low radiation burden, is appropriate in lymphoma Methods: Systematic review and meta-analysis of randomized controlled trials comparing HDT and ASCT after achievement of complete remission (CR) or patients especially with supradiaphragmatic localization of the lesions. In partial remission (PR) to standard dose chemotherapy, with or without rituximab patients with small subdiaphragmatic lesions (<15 mm) and inconclusive as first line treatment in patients with aggressive NHL. The Cochrane Library, 99mTc- Tetrofosmin scintigraphy, PET-CT is method of choice. MEDLINE, conference proceedings and references were searched until December 2013. The primary outcome was overall survival (OS). Secondary outcomes were relapse rate, overall response (ORR), CR and secondary PB1815 malignancies. For dichotomous data, relative risk (RR) with 95% confidence BENDAMUSTINE PLUS RITUXIMAB FOR RELAPSED OR REFRACTORY intervals (CIs) were estimated and pooled and hazard ratios (HR) for time to DIFFUSE LARGE B CELL LYMPHOMA: A RETROSPECTIVE STUDY event data were estimated and pooled. We used fixed effect model to pool F Merchionne 1,* G Quintana 1, C Minoia 2, A Guarini 2, I Galise 3, G Quarta 1, results. G Loseto 2, A Melpignano 1 Results: Our search yielded 20 trials conducted between the years 1987 and 1Hematology Unit , Ospedale Antonio Perrino , Brindisi, 2Department of Medical 2011, including 4488 patients. In five trials rituximab was added to both arms. and Experimental Oncology, Hematology Unit, IRCCS National Cancer Median age of patients ranged between 31 to 51 years old. Seven trials Research Centre “Giovanni Paolo II”, 3Registro Tumori Puglia, IRCCS National included only patients with intermediate-high and high risk age-adjusted Cancer Research Centre “Giovanni Paolo II”, Bari, Italy international prognostic index (aaIPI). Ten trials were judged to be at low risk for selection bias (allocation concealment and sequence generation).Data from Background: After standard R-CHOP therapy, patients with relapsed or 19 trials were available for analysis of OS. Treatment with HDT and ASCT did refractory diffuse large B cell lymphoma (DLBCL) are generally treated with not improve OS as compared to standard dose chemotherapy, HR 1.09, 95% 2 aggressive salvage chemotherapy followed by high dose therapy with confidence interval (CI) 0.98-1.21, I for heterogeneity 32%. Also, no survival autologous stem-cell transplantation (ASCT). However, for patients who are not benefit was shown in a sub- analysis of patients with intermediate-high and high 2 eligible for intensive chemotherapies and ASCT because of comorbidities aaIPI (HR 1.08 95% CI (0.95-1.24), I =66%, 10 trials). However, HDT and and/or advanced age or relapse after heavy salvage regimens, treatment ASCT was associated with an increased rate of CR [RR 1.07 95% CI (1.02- options are very limited and prognosis is poor. Based on the demonstration of 1.11)], and a decreased rate of relapse, RR 0.58 95% CI (0.49-0.69). No efficacy and safety of bendamustine plus rituximab (BR) in patients with indolent statistically significant difference was observed regarding the incidence of and mantle cell non-Hodgkin lymphomas in terms of increased progression-free secondary malignancies. survival and fewer toxic effects than R-CHOP, additional studies are being HDT and ASCT as first line treatment for Summary and Conclusions: carried out to assess the activity and safety of this combination in patients with aggressive NHL is not associated with increased OS, yet it improves CR rate DLBCL not eligible for intensive chemotherapy regimens. and decreases relapse rate. The possibility to salvage relapsing patients with Aims: To analyze a group of patients with relapsed or refractory DLBCL treated HDT and ASCT may contribute to the lack of effect of this treatment on OS when with combination BR between July 2010 and January 2014, and to evaluate given as first line therapy. overall response rate (ORR), progression-free survival (PFS) and treatment safety. Methods: Of 22 patients registered, 19 (14 males and 5 females) are currently PB1814 available for this analysis. Patients gave informed consent. The median age USEFULNESS OF 99M TC-TETROFOSMIN SCINTIGRAPHY IN THE was 71 years (range 54-82); ECOG performance status was 1 (n=6, 27.2%), FOLLOW UP IN PATIENTS WITH MALIGNANT LYMPHOMA IN THE ERA OF 2 (n=15, 68.1%) and 3 (n=1, 4.5%); R-IPI scores before starting therapy were 18F-FDG PET-CT good (n=13, 59%) and poor (n=9, 41%). The median number of prior D Vassileva 1,* B Spassov 2, S Sergieva 3, M Garcheva 4, I Kostadinova 4 chemotherapy regimens was 2 (range 1-5); lactate dehydrogenase was 1Nuclear Medicine, 2Clinical hematology, NSBALHZ, 3Cancer Center, 4Nuclear elevated in 12 patients (54.5%) and normal in 10 (45.4%). The Ann Arbor Medicine, University Hospital Alexandrovska, Sofia, Bulgaria clinical stage at baseline was IV (n=8, 36.3%), III (n=8, 36.3%), and II (n=6, 27.2%). Rituximab was administered at the standard dose of 375 mg/m 2 and Background: In patients with malignant lymphomas the precise staging and bendamustine at a dose between 70 and 120 mg/m 2 (mean 90 mg/m 2) on days follow up is very important for treatment and prognosis of these patients. 1 and 2 of each 28-day cycle for up to six cycles. Nine patients (41%) completed 99mTc-Tetrofosmin is currently used to study myocardial perfusion, but also has six cycles of treatment and the median number of cycles received per patient been reported to be localized in various types of malignant tumours, including was 5 (range 1-6). lymphomas, giving their localization and proliferation activity. With previously Results: ORR was 47.3% (complete response: n=7 patients, 36.8% and partial used visualized techniques it has been extremely difficult to differentiate response: n=2 patients, 10.5%), with stable disease in 1 patient (5.2%) and metabolically active tumour tissue from post-therapy fibrosis. Nowadays 18F- progression disease in 9 patients (47.3%). At the median follow up of 6.4 FDG PET-CT is a method of choice for these applications. months (range 1 to 37.4 months), the median PFS was 7 months (95% CI 4.4 Aims: In this study, we aimed to evaluate the role of 99mTc-Tetrofosmin - 26.6) for all patients. Four patients showed remission lasting longer than 24 scintigraphy for therapy control of lymphoma patients in the era of 18F-FDG months. Grade 3 / 4 toxicities observed were: lymphopenia (42.1%), PET-CT.