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CLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES FOR YOUNG PATIENTS WITH FIRST‐LINE FOLLICULAR LYMPHOMA: A POOLED ANALYSIS OF 4249 PATIENTS FROM THE FLASH DATABASE.

grade B‐cell non‐Hodgkin lymphomas (NHL) is rare and has only been reported as case series. The distribution, demographics and outcomes of patients with low grade CNS NHLs have not been well characterized. Methods: The National Cancer Database (NCDB) represents ~70% of cancer cases in the United States. Using the 2004–2013 NCDB extranodal NHL database, we identified all CNS B‐cell NHLs based on ICD‐O‐3 site and histology codes. Primary or secondary CNS involvement could not be determined. Results: Out of 9435 CNS NHL cases, 475 [5.03%] had low grade histologies. In this group, the median age at diagnosis was 58 years [range 19–89]. Majority of the cases were female [56%], White, non‐Hispanic [72%], privately insured [53%], with no comorbidities [74%] and treated in academic/research programs [38%]. Site of CNS disease was not specified in 22%. HIV status was known in 318 cases (6.3% positive). The brain [44%] was the most common site of involvement followed by spinal cord [19%] and meninges [15%]. Follicular lymphoma (FL) [48%] was the most common histology overall followed by marginal zone (MZL) [37%], small lymphocytic (SLL) [8%] and lymphoplasmacytic lymphomas (LPL) [7%]. MZL was the most common histology in the brain [44%] and meninges [61%] while FL was most common in the spinal cord [77%] and nervous system, NOS, [69%]. Cranial nerves and eye (retina/optic nerve) involvement was very rare [2 and 1 case each—both MZL].The overall survival (OS) of CNS B‐cell NHL was significantly better if histology was low grade vs other [5‐year OS 74% vs 32%, P < 0.0001]. Among CNS low grade B‐cell NHLs, 5‐year OS was significantly affected by histology [MZL 83%, FL 75%, LPL 56% and SLL 50%, P = 0.0003] and site of disease [spinal cord 89%, meninges 78% and brain 63%, P = 0.03] in addition to age at diagnosis and co‐morbidities on both uni‐ and multivariate analysis. Survival was not influenced by sex, race, insurance, year of diagnosis, facility type or location. Conclusions: CNS involvement with low grade B‐cell NHL is rare but has a relatively good outcome with most patients surviving beyond 5 years. FL and MZL are the more common low grade histologies. Both histology and disease site are important factors affecting survival.