Joseph Mikhael, MD, MEd
Consultant Hematologist, Mayo Clinic Arizona; Associate Professor, Mayo College of Medicine
Editor-in-Chief, ASH News Daily 2011
For more than 50 years, ASH has hosted the largest and most influential meeting for those interested in the basic and clinical science of hematology. Every year, for four packed days, individuals from all over the world meet to review and discuss the latest research in the field and its implication for patients with blood diseases. Indeed, attendance this year was the second highest on record with more than 22,000 participants (representing 71 countries) registered for the meeting. (The 50th ASH Annual Meeting in 2008 was the highest attendance on record.) Furthermore, more than 6,000 abstracts were submitted, of which 1,032 were selected for oral presentations and 3,198 were presented as posters.
This past meeting, held in “not always sunny” San Diego, was a fascinating merger of past and present; we looked back at great accomplishments and saw both how they have shaped the standards of the present and how they will surely enhance the discoveries of the future. Here is the executive summary.
The rich history of our specialty was represented at the meeting. The Ham-Wasserman Lecture is given annually by an investigator from outside of the United States who has made important contributions to hematology. This year’s iteration addressed the subject of angiogenesis and was masterfully presented by Dr. Peter Carmeliet, Katholieke University of Leuven, Belgium. Dr. Carmeliet delivered an inspiring overview of 30 years of dedicated investigation that has led to an appreciation of the importance of the biology and pathobiology of angiogenesis. And from his unique perspective, Dr. Carmeliet provided an overview of how an understanding of angiogenesis currently affects patient care and how this knowledge may lead to new therapeutic options for treating neoplastic diseases.
Stem cell biology was the subject of the E. Donnall Thomas Lecture, as the career of Dr. George Q. Daley, Children’s Hospital Boston and Howard Hughes Medical Institute, was profiled. His lecture, “Hematopoietic, Embryonic, and Induced Pluripotent Stem Cells: Diseases, Myths, and Medicine,” was a stirring recounting of the history of stem cell research. Dr. Daley elegantly reviewed the scientific accomplishments and the political implications that have kept this complex subject in the forefront of biomedical research for more than a decade. Finally, he tantalized us with how his group and others are using “disease in a dish” technology (i.e., the creation of induced pluripotent of stem cells from patients with genetic disorders) to develop novel approaches to the treatment of inherited diseases such as congenital bone marrow failure syndromes.
Chronic myeloid leukemia (CML) was the focus of the Ernest Beutler Lecture and Prize. Named for a former ASH president and prototypical physician-scientist, this award recognizes excellence in an area that bridges basic and clinical sciences. Dr. Janet Rowley, University of Chicago Medical Center, and Dr. Brian Druker, Knight Cancer Institute, Oregon Health & Science University, recounted one of hematology’s great stories — from discovery of the Philadelphia chromosome to development of oral therapy for CML. Indeed, Dr. Rowley’s work on “personalizing” cancer therapy led to breakthroughs that were developed further by Dr. Druker and others into tyrosine kinase inhibitors that target CML. We dream that this pattern of developing targeted therapy could be repeated in all cancers!
The Society’s highest honor, the Wallace H. Coulter Award for Lifetime Achievement in Hematology, was bestowed on Dr. David Nathan, Dana-Farber Cancer Institute and Children’s Hospital Boston. His seminal work on the use of hydroxyurea for treatment of patients with sickle cell disease and on iron chelation to reduce the morbidity of iatrogenic hemochromatosis in patients with thalassemia has improved the lives of thousands of patients. His career is a model for all of us, not only in the depth of the science, but also in the commitment to patients, colleagues, and mentees.
The heart of the meeting remains the educational and scientific sessions. Covering all major areas of basic science and clinical hematology, these sessions present the most up-to-date information in our field. Nearly 30 Education Program sessions addressed benign, malignant, adult, and pediatric hematology. Attendees were provided with expert insight into basic mechanisms of disease and their therapeutic implications by nearly 100 lecturers. To ensure that these lectures will be available for future reference, the essence of each presentation (authored by the lecturer) is available in manuscript form in Hematology 2011, the Education Program Book.
The Education Program was complemented both by the Scientific Program, with sessions representing each of the 17 scientific subcommittees, and Education Spotlight Sessions that highlight controversial and “hot” areas of hematology.
Looking at the sessions as a whole, it is remarkable how far we have come in the last decade in hematology. Diseases that were previously characterized by an aggressive, rapidly fatal course have been made chronic, our understanding of the mechanisms of disease has deepened, and therapeutic targets have been accurately hit.
The pace and volume of research continues to expand (in a seemingly exponential fashion). The oral and poster abstracts presented at this meeting demonstrate how rapidly hematology is evolving, and how different the near future will be from the past and present.
Six of the highest rated abstracts, comprising the Plenary Scientific Session, were presented to a large, enthusiastic audience. I have had the privilege of attending the Plenary Session for the last 12 years and have yet to see crowds of similar size. Dr. Claudio Anasetti summarized the results of a trial of marrow versus filgrastim-mobilized peripheral blood as the source of stem cells for patients undergoing unrelated donor transplant. A higher incidence of graft-versushost disease was noted with the filgrastim-mobilized stem cell source, but no survival difference was observed between the two treatment arms after three years of observation. These findings may encourage greater use of bone-marrow-derived stem cells for patients undergoing unrelated donor transplant.
Dr. Amit Nathwani presented groundbreaking work in treatment of hemophilia. Six patients with hemophilia B who underwent a trial of gene therapy showed a reduction in the grade of their hemophilia from severe to either mild or moderate. This trial represents, at minimum, the first step in downgrading the severity of this life-threatening chronic disease.
Other presentations included a report on the development of an immortalized megakaryocyte cell line that suggested the possibility of creating a source of unlimited platelets of recipient origin; a report on somatic mutation in patients with sideroblastic anemia of a gene (SF3B1) involved in RNA splicing, an elegant abstract presentation that dealt with identification of the earliest genetically characterized pre-leukemic cell; and a report that suggested a survival advantage for patients with acute leukemia who received, as part of their induction regimen, gemtuzumab ozogamicin (a drug that was withdrawn from the U.S. market in 2010).
The increasing presence of trainees and trainee events at the annual meeting makes me proud to be a part of this Society. Over the last decade, we have seen the formation of the Trainee Council, Trainee Day, sessions devoted to trainees, and workshops on career development and grant writing. This year’s meeting was no exception. Outstanding sessions included “The Secret to Getting Funded,” “Drug Development: Bench to Bedside and Beyond,” and “How to Publish a Manuscript in a Peer-Reviewed Journal.” Suffice it to say the future looks bright.
This report only scratches the surface of the meeting. There were numerous other sessions, meetings, receptions, and activities, all of which contribute to the success of the ASH annual meeting. This was the most “connected” annual meeting ever with free WiFi throughout the convention center, a new ASH annual meeting mobile application, an electronic ASH News Daily, and live Twitter updates. Consequently, the reach of the meeting went far beyond San Diego.
A critical aspect of the meeting that I have to mention is the social one. Not only is the meeting a great opportunity for professional and mentorship networking (that leads to international collaborative efforts), but it is also a lot of fun. Many a good meal was had in the Gaslamp District, and I hope many were able to enjoy the “outdoor” sessions that included a beautiful, refreshing view of the ocean. It was difficult to pass up the opportunity to slip outside between sessions and soak up the weather and culture of San Diego.
I would like to thank all of those who contributed to ASH News Daily for their hard work in making the publication such a success. With headlines such as “Platelet Pandemonium,” “Chocolate, Vanilla or Both: Making Choices in Myeloma,” and “Bone Marrow Harvest Time: Are We Going Back to the OR?,” we trust you found the articles both informative and entertaining.
You can still access them online at http://www.hematology.org/Meetings/Annual-Meeting/. The authors were Drs. Michael Bishop, Amanda Brandow, David Garcia, Shari Ghanny, Heather Landau, Julie Panepinto, Barbara Pro, and Michael Rosenzweig. Special thanks to the ASH staff; it was such a delight to work with the whole team.
I hope you are already making plans for Atlanta in 2012.
Annual Meeting Materials
To purchase a copy of the 2011 Annual Meeting Education Program DVD, go to the ASH Store.
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