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Determinants of overall survival (OS) of primary plasma cell leukemia (pPCL): A National Cancer Database (NCDB) analysis of years 2004 to 2009.

8066 Background: Outcome data for pPCL is limited due to the rare & aggressive nature of the disease. In this retrospective analysis, we utilized NCDB to identify factors contributing to 1 & 5-year OS of pPCL patients treated at CoC-accredited facilities across USA. Methods: Using the NCDB, we identified N= 325 pPCL patients diagnosed between 2004-2009 after excluding entries missing relevant values. Univariate analysis was used to summarize & assess the potential survival factors individually & multivariate Cox regression analysis with backward elimination (using significance level of p<0.05) was utilized to identify the independent survival factors. Kaplan-Meier (KM) survival curves of patient cohort were also produced. SAS version 9.4 was used to analyze the data. Results: Multivariate Cox regression analysis with backward elimination method revealed that there were 4 significant independent survival factors including sex, Charlson-Deyo Comorbidity Index (CCI), facility type, and insurance, while age & year-of-diagnosis were not independent survival factors (Table). Male patients were more likely to die compared to female patients (HR=1.40, p=0.005); patients with CCI ≥1 had higher chance to suffer death compared to patients with CCI= 0 (HR=1.52, p=0.002); patients not treated at an academic center (AC) had lower survival compared to those treated at ACs (HR=1.35, p=0.001); and patients without private insurance (PI) were more likely to suffer death compared to those with PI (HR=1.54, p=0.001). The 1 & 5-year survival rates for whole cohort were 51.3% (95%CI: 45.8%-56.8%), and 18.9% (95%CI: 14.6%-23.2%) using KM estimate, respectively. Only 6/325 =1.8% patients underwent autologous hematopoietic stem cell transplant (HSCT). Detailed analysis will be presented. Conclusions: In this large analysis of pPCL patients, we identified that being female, having less comorbidities, getting treatment at ACs, and having PI had significantly greater OS. Overall, pPCL is associated with low survival rates both at 1 & 5-years and HSCT may be enormously under-utilized for pPCL patients in the real world setting. [Table: see text]