S112 © American Society for Clinical Pathology AJCP / Meeting AbstrActs Am J Clin Pathol 2018;150:S93-S115 DOI: 10.1093/AJCP/AQY097 patients with HM who had peripheral blood fow cyto- metric (PBFC) tests, seven cases were positive for atyp- ical/neoplastic populations concordant with the fnal diagnosis either in bone marrow or tissue, whereas none of fve non-HM cases were positive. The sensitivity and specifcity of PBFC to predict HM were 78% and 100%, respectively. The percentage of the neoplastic population ranged from 0.55% to 92% and was higher in one case of acute myeloid leukemia. The immunophenotypic profle, including large cell size, was suffciently aberrant to distin- guish from indolent clonal lymphocytosis. Conclusion: Our study demonstrated the predictive power of PBFC for diagnosing hematolymphoid malignancy in HLH patients with a high sensitivity and specifcity. We recommend PBFC (with a STAT result available in hours) to be used as an initial screening test in cases where there is high clinical suspicion for HLH and HM followed by con- frmatory tissue diagnosis. This process may aid in a timely diagnosis and treatment to improve the clinical outcomes. Epstein-Barr Virus, Human Herpesvirus 8, and Human T-Lymphotropic Virus Type 1 Infections Amongst Patients With Lymphoid Malignancies: Exploring Causal Relationship, in Calabar Bassey Bassey, MB, BCH, 1 Marcus Asuquo, MD, FMCPath, 1 and Alani Akanmu, FMCPath 2 ; 1 University of Calabar Teaching Hospital and 2 Lagos University Teaching Hospital Objectives: To determine the prevalence of EBV/HHV-8/ HTLV-1 among patients with LM and compare with con- trols. To determine the relationship between history of blood transfusion, socioeconomic data, and blood indices with positivity of oncogenic viruses. Methods: A total of 180 participants who gave informed consent were recruited, 60 with LM and 120 controls. Socioeconomic data and history of blood transfusion were obtained through questionnaire. Ten milliliters of blood was collected from each patient: 5 mL into EDTA for FBC and 5 mL into a plain bottle for ELISA to test for oncogenic viruses. Results: LM population had EBNA IgG prevalence of 76.7%, while controls had 75.0% (P = .806). EBNA IgM prevalence for LM patients and controls was no different from each other (8.3%) (P = 1.000). HHV-8 prevalence for LM patients had 5% while controls had 11.7% (P = .149). None (0%) of the study participants was positive for HTLV- 1. Participants who had never received a blood transfusion had 75.7% positivity for EBNA IgG, 9.3% for EBNA IgM, and 10% for HHV-8. Those transfused had 75% positivity for EBNA IgG, 5% for EBNA IgM, and 7.5% for HHV-8 (EBNA IgG, P = .926; EBNA IgM, P = .387; and HHV-8, P = .633). Concerning only patients with LM, 30 (65.2%) positive for EBNA IgG had received blood while 16 (34.8%) had not (P = .666). Two (40%) positive for EBNA IgM had received blood while three (60%) had not (P = .186). The three patients who were positive for HHV-8 had received a blood transfusion. There were statistically signifcant dif- ferences between the various blood indices of LM patients and the controls (P < .05), except MCH, which was not signifcant (P = .115). There was no statistically signifcant difference between the socioeconomic data of LM patients who were infected with the oncogenic viruses and those who were not (P > .05). Conclusion: The study shows that oncogenic viruses are not frequently associated with LM in Calabar, and blood transfusion does not incur any additional risk. Plasma Cell Neoplasms (PCNs) With Low-Risk, Favorable Gene Expression Subtypes Are More Often Associated With Therapy-Related Myelodysplastic Syndrome (t-MDS) Anwar Rjoop, MD, Rodolfo Henrich Lobo, MD, Soumya Pandey, MD, and Daisy Alapat, MD; University of Arkansas for Medical Sciences Objectives: t-MDS are clonal hematopoietic disorders that develop secondary to chemotherapy and/or radiation therapy. Prior studies have shown a complex karyotype and abnormalities involving chromosomes 5 and 7 in PCN patients developing t-MDS. However, these abnor- malities can be seen in both de novo MDS and t-MDS, and it can sometimes be challenging to differentiate mul- tiple myeloma/MDS signature from t-MDS. This study was performed to identify patterns of gene expression profling (GEP) and any novel karyotypic abnormalities in newly diagnosed t-MDS in patients with a history of treated PCNs. Methods: A retrospective review was performed to iden- tify any new diagnosis of t-MDS on bone marrow exam- ination in all patients undergoing treatment at UAMS for PCNs during 2014 to 2016. Thirty-four patients were identifed. Additional data were collected, including GEP based on our previously published UAMS protocol, karyotype analysis, and myeloid mutational profle using NextGen sequencing. Results: GEP analysis showed a low-risk gene class with favorable prognosis in the majority of the patients (26/34, 84%). On GEP subgroup analysis, hyperdiploid (HY) and cyclin D2 (CD2) (10 in each category, 31%) were most commonly seen. Abnormalities of chromo- somes 5 (10/34; 29%) and/or 7 (8/34; 23%) and a complex karyotype (28/34; 82.3%) were noted in a majority of the patients, similar to prior studies. In addition, we observed an unbalanced dicentric translocation dic(5;17) (q11;p11) in ~29% patients. NGS analysis performed on a subset of the patients revealed TP53 as the most common gene mutation (81%). Downloaded from https://academic.oup.com/ajcp/article/150/suppl_1/S112/5102936 by guest on 15 March 2022