Mary Jo Lechowicz, MD
Division of Bone Marrow Transplant, Department of Hematology and Oncology, Winship Cancer Institute of Emory University Editor-in-Chief, ASH News Daily 2010
As we return from another wonderful ASH meeting in Orlando, FL, we reflect on the meeting and some of the highlights. Just like our host site of Orlando, with diverse attractions from the sea, space, wizards, and mice, our ASH meeting and attendees represent a heterogeneous population. This year, there were 21,112 registered attendees from approximately 97 countries. Equally distinctive were the presentations at this year’s meeting. Here are a few highlights for all to remember from the meeting.
This year’s Ham-Wasserman Lecture featured Dr. Tsvee Lapidot, the current Edith Arnoff Stein Professorial Chair in Stem Cell Research at the Weizmann Institute in Rehovot, Israel. His career has focused on the mechanisms of hematopoietic stem and progenitor cell movement. He illustrated the complexity of the homing process and the many systems involved in this process. The sections of this intricate choreography between chemokines, bone turnover mechanisms, the nervous system, and the microenvironment are continuing to be described. Future understanding has the potential to change the mechanics of bone marrow transplantation, particularly stem cell processing and collection, which may continue to improve outcomes for our patients undergoing this therapeutic strategy.
To dovetail the Ham-Wasserman Lecture, the Presidential Symposium reflected on transplantation — from the viewpoint of the evolution of the field of umbilical cord blood transplantation (UCBT). The symposium presented the state of cord blood transplantation and research in the field currently. A core investigator in the evolution of UCBT as we know it today is Dr. Hal Broxmeyer, who completed his year as ASH president in resounding style. Since then, with the further development of this area for the clinical use as a hematopoetic stem cell reservoir, many questions have arisen clinically regarding the use of UCBT in patients. Dr. Eliane Gluckman of Hôpital Saint-Louis in Paris addressed ones such as where the field is with single cord blood units and its ongoing improved success in outcomes. To tackle the challenge of delayed engraftment, Dr. John Wagner of the University of Minnesota reviewed recent research on potential strategies to combat this challenge including exvivo manipulation of the graft. Finally, Dr. Joanne Kurtzberg of Duke University discussed the success of cord blood transplantation in the treatment of non-hematologic diseases including inherited metabolic storage disorders. She spoke about how these lessons have been extended into the use of cord blood in tissue repair and regeneration, focusing on genetic and acquired brain injuries.
A unique session at this year’s meeting was a symposium in celebration of the National Institute of Diabetes and Digestive and Kidney Diseases’ (NIDDK) 60th anniversary. Dr. Kenneth Kaushansky presented hematopoiesis and its labyrinth of cell signaling to create and maintain order to the process. Dr. Alan Schechter then discussed where the field of hemoglobin research has come historically and the direction it is headed in the future. Particularly, one focus was on nitric oxide, its effects on vascular tone, and differences in severe hemolytic states with new approaches to treatment. Lastly, Dr. Nancy Andrews directed the audience through what we currently know regarding the control of iron balance and advances in pathogenesis of diseases in which this delicate balance is in dysregulation. With this great presentation for a backdrop, we were all able to more fully digest one of the plenaries in particular.
The plenary abstract titled “Anopheline Orthologs of the Human Erythroid Heme Exporter, FLVCR, Export Heme: Potential Targets to Inhibit Plasmodium Transmission” took us through a story of a different way of thinking to possibly tackle a global parasite. As we all know, the virulence of Plasmodium infection is a worldwide health problem. Dr. John G. Quigley discussed a human erythroid progenitor cell membrane transporter, FLVCR, which protects cells from the possibility of excess heme toxicity. The group hypothesized that the dysregulation of anopheline analog of the feline leukemia virus-C receptor (FLVCR)-mediated heme export by the mosquito midgut epithelium could increase oxidative stress and alter Plasmodium transmission. The data presented showed mosquitoes administered with anti-FLVCR antibody or inhibitory RNA showed increased reactive oxygen species and decreased cell survival. It will be exciting to watch this story unfold if this approach to directly alter the mosquito can lead to the inhibition of Plasmodium transmission.
Continuing the theme of a challenge of far-reaching effects and proportions, on Sunday, we had a rare visit and discussion from a White House advisor, Dr. Ezekiel J. Emanuel. Dr. Emanuel is an oncologist who serves as a special advisor for health policy in the Office of Management and Budget of the White House. ASH and the European Hematology Association sponsored a joint symposium in which Dr. Emanuel spoke about the historical significance for health-care reform and the Patient Protection and Affordable Care Act. He also recommended ways in which physicians can prepare for the provisions of the new law, including implementing electronic medical records in their practices and developing quality indicators and treatment guidelines for their specialties. He touched on how all of this is germane not only to the United States but to our foreign colleagues as well. During the question-and-answer session, Dr. Emanuel validated and appreciated ASH representatives’ willingness to volunteer aid in this time of change. This session underscored the changing times of health care as we have come to know it and to be ready for what the future will bring.
This ASH meeting was wonderful to cover and bring to you as it had so much to offer. ASH News Daily’s coverage would not have been possible without the diverse expertise of this year’s writing team — Drs. William Blum, Mark Frattini, Stephen Hunger, Jason Mendler, Chris Porter, Naveen Manchanda, and Erin Gourley Reid — whose intelligence, knowledge, and esoteric references and puns made for a quality product. Special thanks to Dr. David Steensma who created our crossword puzzle for the second year in a row. The articles from ASH News Daily 2010 can be found on the ASH website at www.hematology.org/Publications/ASH-News-Daily/2010/5970.aspx.
We are always looking for feedback. We are looking forward to 2011 and another exciting meeting in San Diego, nicknamed America’s finest city!
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