American Society of Hematology

Education Program

Review in-depth analysis of each Education Program session presented at the ASH annual meeting. Learn more

The ASH Education Program will be held from Saturday, December 7, through Monday, December 9, with most sessions being offered twice. A question-and-answer period will occur at the end of each individual speaker presentation.

Chapters based on these sessions will be published in Hematology 2019, the ASH Education Program.

2019 Education Program Co-Chairs

Elisabeth Battinelli, MD, PhD

Elisabeth Battinelli, MD, PhD
Brigham and Women's Hospital
Boston, MA

Jason Gotlib, MD, MS

Jason Gotlib, MD, MS
Stanford University School of Medicine
Stanford, CA

Junior Faculty Career Development Session


Session Offered Once
Sunday, December 8, 2019, 4:30 p.m. - 6:00 p.m.
Orange County Convention Center, W307, Level 3

This education session is designed for junior faculty to discuss career development skills that are not typically taught during fellowship. This year’s theme is The Search for an Academic Job: Understanding the Basics and will cover early career topics, including negotiating, presented by a panel of esteemed faculty. The first speaker will provide introductory remarks and then serve as moderator for panel discussion.

Chair:

Rakhi P. Naik, MD
Johns Hopkins Hospital
Baltimore, MD

Speakers:

Marc J. Kahn, MD, MBA
Tulane University
New Orleans, LA
Understanding Promotion and Tenure

Eric Pietras, PhD
University of Colorado
Aurora, CO
Looking for an Academic Job and Show Me the Money: Negotiating Your Salary and Benefits

Jose A. Lopez, MD,BS
Bloodworks Northwest
Seattle, WA
Looking for an Academic Job and Show Me the Money: Negotiating Your Salary and Benefits

Sara E. Meyer, PhD
Thomas Jefferson University, Sidney Kimmel Cancer Center
Philadelphia, PA
Looking for an Academic Job and Show Me the Money: Negotiating Your Salary and Benefits

Siddhartha Jaiswal, MD,PhD
Stanford University
Stanford, CA
Looking for an Academic Job and Show Me the Money: Negotiating Your Salary and Benefits

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Sessions on Malignant Hematology

Acute Lymphoblastic Leukemia: Aiming High to Keep MRD Low, or Even Better, Negative


Session Offered Twice
Monday, December 9, 2019
7:00 a.m. - 8:30 a.m.

Orange County Convention Center, Chapin Theater (W320), Level 3
Monday, December 9, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, Valencia BC (W415BC), Level 4

The landscape of ALL has evolved significantly from both the biologic and treatment standpoint. This session will focus on the increasing incorporation of minimal residual disease (MRD) into treatment decisions for ALL. In addition, we will discuss strategies being explored in patients with newly diagnosed and relapsed/ refractory ALL: the addition of novel agents into treatment, the use of pediatric regimens in adult ALL, and treatment with second and third generation tyrosine kinase inhibitors (TKIs) in Philadelphia-chromosome (Ph)+ ALL.

Dr. Anjali Advani will discuss the prognostic impact of MRD and its use in treatment decisions. She will also discuss the novel agents: antibody-based treatments (blinatumomab and inotuzumab), bcl-2 inhibitors, and TKIs (for Ph-like ALL) and their incorporation into the treatment of ALL.

Dr. Lori Muffly will summarize the results of recent trials evaluating pediatric-inspired regimens in adults with ALL and the steps moving forward in this arena.

Dr. Adele Fielding will review the promising results with second and third generation TKIs in combination with chemotherapy for Ph+ ALL and the controversies surrounding the question of allogeneic hematopoietic stem cell transplant for these patients.

Chair:

Anjali S. Advani, MD
Cleveland Clinic
Cleveland, OH

Speakers:

Anjali S. Advani, MD
Cleveland Clinic
Cleveland, OH
Navigating the Nexus of MRD and Novel Agents in ALL

Lori S Muffly, MD
Stanford Cancer Institute
Stanford, CA
Pediatric-inspired Protocols in Adult ALL: Are the Results Bearing Fruit?

Adele K. Fielding, MBBS,PhD,FRCP,FRCPath
UCL Cancer Institute
London, United Kingdom
Ph+ ALL: Is Chemo+TKI or Transplant the Best Road to Cure?

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Aggressive Non-Hodgkin Lymphomas: It's Getting Personal


Session Offered Twice
Monday, December 9, 2019
10:30 a.m. - 12:00 p.m.

Orange County Convention Center, Chapin Theater (W320), Level 3
Monday, December 9, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, Tangerine 2 (WF2), Level 2

Major advances in gene expression and deep sequencing analyses have generated unprecedented insight into disease biology of non-Hodgkin lymphoma subtypes with important prognostic and therapeutic implications. This session will delineate evolving treatment strategies in mantle cell lymphoma and peripheral T-cell lymphoma and bring in focus circulating tumor DNA as biomarker for potential clinical application.

Dr. Jia Ruan will review most recent molecular profiling data of mantle cell lymphoma and its application in contemporary diagnosis, prognosis and treatment stratification. She will discuss current management approach in the upfront and relapse settings in the context of molecular biomarkers to correlate disease biology with treatment outcome. Dr. Ruan will then discuss ongoing and emerging clinical strategies incorporating molecular biomarkers to optimize therapy.

Dr. Neha Mehta-Shah will discuss current approaches for the treatment of common subtypes of peripheral T-cell lymphoma in the upfront setting as well as in the relapsed setting. She will review the biologic rationale for future therapeutic strategies in these rare but difficult-to-treat lymphomas. Dr. Mehta-Shah then will address ongoing and emerging trials aimed to improve the treatment of patients with PTCL in both upfront and relapsed settings.

Dr. David Kurtz will discuss the current and emerging data supporting circulating tumor DNA in aggressive NHLs. He will review the broad landscape of methodologies for detecting circulating DNA, focusing on their strengths and weaknesses. Dr. Kurtz will then review the potential uses of circulating tumor DNA in NHLs, including tumor genotyping, relapse detection, and early response prediction, with a focus on translation into the clinic.

Chair:

Jia Ruan, MD, PhD
Weill Cornell Medicine
New York, NY

Speakers:

Jia Ruan, MD, PhD
Weill Cornell Medicine
New York, NY
Molecular Profiling and Management of Mantle Cell Lymphoma

Neha Mehta-Shah, MD
Washington University in St Louis
St. Louis, MO
Emerging Strategies in Peripheral T-Cell Lymphoma

David M. Kurtz, MD,PhD
Stanford Cancer Institute
Stanford, CA
Prognostication with Circulating Tumor DNA: Is it Ready for Prime Time?

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Aging and Hematologic Disorders: Exploring the Evidence


Session Offered Twice
Sunday, December 8, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, Valencia BC (W415BC), Level 4
Monday, December 9, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, W307, Level 3

Older adults represent the growing majority of patients diagnosed with hematologic disorders yet remain under-represented on clinical trials. These patients often present with unique treatment challenges and variable clinical trajectories. Important considerations among older patients, such as treatment tolerance and physiologic reserve, cross many different disease- and treatment-specific challenges. This educational session will explore the evidence for best practices for assessing and managing older adults with hematologic disorders including a focus on use of geriatric assessment measures to personalize care. Last, the session will discuss strategies to facilitate optimal trial design to generate evidence reflective of patients seen in practice inclusive of those with comorbidity and frailty.

Dr. Heidi Klepin will outline the evidence for use of geriatric and frailty assessment in hematologic malignancies to inform treatment decision making and management. She will discuss implementation challenges, effectiveness of identifying and intervening upon geriatric deficits, and the impact on clinical decision-making. This talk will outline strategies by which use of geriatric assessment can enhance the quality of health care delivery (e.g. decision-making, patient experience, healthcare utilization) for older adults through provision of personalized care.

Dr. Rebecca Olin will discuss the challenge of providing intensive therapies for older adults including optimized patient selection and toxicity mitigation. Focusing on AML induction chemotherapy and stem cell transplantation, she will discuss the application of available data for use of geriatric measures in patient evaluation and management.  Using a case-based approach, Dr. Olin will suggest best practices in areas with limited data.

Dr. Paul Hamlin will discuss the opportunities and challenges inherent to design of trials for older adults. He will provide examples of successful design, development and implementation of clinical trials with clinical endpoints relevant to older adults. This talk will address strategies to both understand treatment effects in older adults and explore methodology to accelerate clinical trial enrollment on a larger scale.

Chair:

Heidi D. Klepin, MD,MS
Wake Forest University School of Medicine
Winston Salem, NC

Speakers:

Heidi D. Klepin, MD,MS
Wake Forest University School of Medicine
Winston Salem, NC
How do Geriatric Assessments Impact the Quality of Health Care Delivery Across Hematologic Disorders?

Rebecca L. Olin, MD
University of California, San Francisco
San Francisco, CA
Delivering Intensive Therapies to Older Adults with Hematologic Malignancies: Strategies to Personalize Care

Paul A. Hamlin, MD
Memorial Sloan Kettering Cancer Center
New York, NY
Designing Clinical Trials for Older Adults with Hematologic Malignancies

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Challenges in Myeloma Therapy


Session Offered Twice
Saturday, December 7, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, Hall E1, Level 2
Sunday, December 8, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, Hall D, Level 2

Managing the care of multiple myeloma has become more challenging with the recent advances in risk stratification and the complexities that are further defined with next generation sequencing and genomic characterization of patients with multiple myeloma. As treatment improves and we have more FDA approved agents for myeloma, we begin to ask how and when to treat patients with all of these novel options of therapy available for our patients and how to assess their response, especially the use of MRD testing. In this session, we provide discussion on these hot topics in myeloma and the challenges facing us in managing patients with myeloma.

Dr. Kaufman will summarize recent advances in risk stratification of patients with myeloma. He will describe current definitions of high risk myeloma and how this is changing in the era of next generation sequencing and how to adapt our therapy for patients with high risk myeloma

Dr. Lentzcsh will then discuss the challenges facing clinicians in treating relapsed and refractory myeloma patients who are not eligible for clinical trials. She will describe recent FDA approvals for agents in the refractory setting and how to adapt therapy for refractory myeloma

Dr. Manasanch will clarify challenges in the use of minimal residual disease (MRD) testing in patients with myeloma. She will describe the utility of MRD testing and when to use it in current clinical practice. She will also describe current clinical trials using MRD as endpoints for altering therapy in myeloma.

Chair:

Irene M. Ghobrial, MD
Harvard Medical School
Boston, MA

Speakers:

Jonathan L. Kaufman, MD
Emory University School of Medicine
Atlanta, GA
Roundtable: How Do I Treat a High-Risk Myeloma Patient?

Suzanne Lentzsch, MD, PhD
Columbia University
New York, NY
Roundtable: How Do I Treat a Refractory Myeloma Patient Who is Not Eligible for a Clinical Trial

Elisabet E. Manasanch, MD
The University of Texas MD Anderson Cancer Center
Houston, TX
What to do with MRD Testing in Myeloma

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Expanding Horizons for Immunotherapy in Pediatric Leukemia


Session Offered Twice
Saturday, December 7, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, Tangerine 1 (WF1), Level 2
Monday, December 9, 2019
10:30 a.m. - 12:00 p.m.

Orange County Convention Center, W230, Level 2

While more than 85 percent of children with acute lymphoblastic leukemia (ALL) and 60 percent of children with acute myeloid leukemia (AML) are cured with frontline therapies, relapse and chemotherapy resistance remain major challenges that limit long-term survival. New immunotherapy approaches provide a major paradigm shift in pediatric oncology, often curing previously incurable children. This session will focus upon current clinical strategies to treat children with high-risk ALL and AML with antibody-based and cellular immunotherapies, as well as delineate critical lessons learned from patients who experience immunotherapeutic resistance.

Dr. Lia Gore will summarize successful uses of the bispecific T cell engager blinatumomab, antibody-drug conjugate inotuzumab ozogamicin, and CD19- and CD22-redirected chimeric antigen receptor (CAR) T cells in children with relapsed/refractory B-ALL. She will then discuss current approaches incorporating these immunotherapies into treatment of newly diagnosed children with goals of minimizing relapse and/or decreasing traditional chemotherapy-associated toxicities.

Dr. Sarah Tasian will review current suboptimal outcomes of children with AML treated with conventional therapies and highlight the need for new immunotherapeutic strategies to overcome chemoresistance. She will then discuss the landscape of current and soon-to-open phase i trials of antibody-based and cellular immunotherapies for children with relapsed/refractory AML, as well as the unique potential challenges of these approaches.

Dr. Rebecca Gardner will discuss predictive clinical biomarkers of response and resistance in children with B-ALL treated with antibody-based or cellular immunotherapies. She will then describe new approaches to overcome immunotherapeutic resistance via enhanced CAR constructs, bispecific antigen targeting, combination therapies, and the role of subsequent hematopoietic stem cell transplantation.

Chair:

Sarah K. Tasian, MD
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, PA

Speakers:

Lia Gore, MD
University of Colorado, Children's Hospital Colorado
Aurora, CO
Moving Immunotherapy into the Frontline in ALL

Sarah K. Tasian, MD
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, PA
Opportunities for Immunotherapy in AML

Rebecca Gardner, MD
Seattle Children's Hospital
Seattle, WA
Mechanisms and Approaches to Overcoming Resistance to Immunotherapy

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Hodgkin Lymphoma: Celebrating 200 Years Since Thomas Hodgkin Entered Medicine


Session Offered Twice
Saturday, December 7, 2019
2:00 p.m. - 3:30 p.m.

Orange County Convention Center, Tangerine 2 (WF2), Level 2
Monday, December 9, 2019
7:00 a.m. - 8:30 a.m.

Orange County Convention Center, Tangerine 3 (WF3-4), Level 2

In the recent past, advances in the understanding of Hodgkin lymphoma including insights to the biology of the Reed Sternberg cell and the associated immune microenvironment have rapidly evolved. This knowledge has led to the development of novel drugs and approaches to the disease. This session will discuss unique aspects of Hodgkin lymphoma in elderly patients including the selection of optimal therapy. It will review the rationale for and the use of immunotherapy and targeted agents in the disease. Lastly, the session will explore the financial implications incorporating novel agents into the management of newly diagnosed patients.

Dr. Andrew Evens will review the incidence, biology, clinical presentation, and prognostication for older Hodgkin lymphoma (HL) patients. He will discuss the relevance of geriatric functional measures in the initial assessment and treatment of older patients. Dr. Evens will evaluate past and current treatment options analyzing efficacy and tolerability and provide recommendations for older HL patients with untreated and relapsed/refractory disease. He will also examine the integration of novel therapeutic agents into treatment paradigms.

Dr. Ann LaCasce will review the biology of Hodgkin lymphoma with a focus on the immune microenvironment and the identification of novel therapeutic targets. She will discuss novel agents and immunotherapy approaches in the upfront and relapsed setting.

Dr. Scott Huntington will use the setting of first-line Hodgkin lymphoma as an exemplar case to discuss drug pricing, cost-effectiveness, and budgetary impact in modern oncology. He will then review value-based initiatives that offer the potential to balance innovation, ensure value, and improve equitable patient access to novel cancer therapies.

Chair:

Ann S. LaCasce, MD, MSc
Dana-Farber Cancer Institute
Boston, MA

Speakers:

Andrew Matthew Evens, DO,MMSc
Rutgers Cancer Institute of New Jersey
New Brunswick, NJ
Management of Elderly Patients

Ann S. LaCasce, MD, MSc
Dana Farber Cancer Institute
Boston, MA
Novel Agents and Immune Invasion in Hodgkin Lymphoma

Scott F. Huntington, MD,MPH
Yale University
New Haven, CT
Cure at What (Systemic) Financial Cost?

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Immunotherapy in Myeloma


Session Offered Twice
Saturday, December 7, 2019
2:00 p.m. - 3:30 p.m.

Orange County Convention Center, Hall D, Level 2
Monday, December 9, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, Hall E1, Level 2

Though there have been numerous drugs approved for multiple myeloma over the past decade, the disease is still considered incurable.  Immunotherapy is now being realized as an important and perhaps necessary facet of treatment for this disease.  This realization has been accompanied by a variety of immunotherapy approaches in myeloma, each with a unique mechanism of action.  This session will focus on the various classes of immunotherapy, including a rationale for the mechanisms of action as well as a summary of clinical safety and efficacy data.  The session will also discuss how researchers are combining our clinical experience with pre-clinical and correlative data in an effort to improve safety, efficacy and availability of this exciting class of agents.  

Dr. Nina Shah will summarize the pre-clinical and clinical data on CAR-R cell therapy in multiple myeloma.  She will review the rationale for selection of target antigens (in particular, BCMA) and summarize the early phase I and phase II clinical data, which has shown unprecedented results.  Dr. Shah will also discuss the limitations of this therapy and the many innovative approaches to extending the efficacy of this treatment.  Finally, she will discuss the real-world challenges of bringing CAR-T cell therapy to all myeloma patients as well as how we may sequence various immunotherapy approaches to maximize the duration of response. 

Dr. Adam Cohen will discuss non-cellular, next generation immunotherapy for multiple myeloma.  In particular, he will describe checkpoint inhibitors, antibody-drug conjugates, and bispecific antibodies/BiTEs (bispecific therapeutic engagers).   He will also review the early but impressive clinical data seen with these agents as well as compare their safety to that of cellular therapies.  Dr. Cohen will also touch on the benefits of these therapies over that of cellular therapies and suggest how we may sequence between the numerous immunotherapy options.  

Dr. Ivan Borrello will discuss non-CAR-T cellular therapy approaches, which include vaccine and other T cell strategies.  He will review the rationale for harnessing the power of these components of the immune system and describe the innovative research and procedures developed over the last decade to generate cellular therapies at various academic institutions.  Dr. Borrello will also review the early clinical data generated with these cellular immunotherapies and how they are informing future studies.  Finally, he will discuss the potential for combination of these therapies with existing anti-myeloma therapies or with concurrently developing other immunotherapies.

Chair:

Nina D. Shah, MD
University of California - San Francisco
San Francisco, CA

Speakers:

Nina D. Shah, MD
University of California - San Francisco
San Francisco, CA
CAR-T Therapy - Is it Prime-Time in Myeloma?

Adam D. Cohen, MD
University of Pennsylvania
Philadelphia, PA
Myeloma: Next Generation Immunotherapy

Ivan M. Borrello, MD
Johns Hopkins University
Baltimore, MD
It's Not All CAR-T. Other Cellular Therapy in Myeloma

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Indolent Lymphomas: The Marathon Has a New Course


Session Offered Twice
Saturday, December 7, 2019
2:00 p.m. - 3:30 p.m.

Orange County Convention Center, Tangerine 1 (WF1), Level 2
Sunday, December 8, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, Tangerine 1 (WF1), Level 2

The treatment of indolent B cell non-Hodgkin lymphoma has evolved beyond the sequencing of multiple lines of combination chemotherapy. This session will focus on new strategies for these diseases, including new ways to target CD20, existing and new targeted therapies and combinations, and new immunotherapeutic approaches and tumor antigens. Lastly, we will review where autologous and allogeneic stem cell transplantation fit amidst these increasing treatment options.

Dr. Jeff Sharman will summarize the recent and emerging clinical data of second generation anti-CD20 antibodies, biosimilar antibodies, and subcutaneous formulations. He will discuss the anti-CD20 bispecific antibodies and anti-CD20 chimeric antigen receptor (CAR) T-cells and their clinical efficacy and toxicity to date, as well as review the use of CD20 antibody therapy in combination with innate immune checkpoint blockade with anti-CD47 antibodies.

Dr. Caron Jacobson will discuss available and emerging novel agents for the treatment of indolent lymphomas, including the immunomodulatory drug lenalidomide and related next generation agents, inhibitors of the B cell receptor pathway including inhibitors of Bruton’s tyrosine kinase (BTK) as well as phosphoinositide 3-kinase (PI3k), and immunotherapeutic approaches. She will review their activity and role both in relapsed/refractory as well previously untreated disease.

Dr. Ajay Gopal will discuss the data regarding the use of autologous and allogeneic transplantation for patients with follicular lymphoma. He will also review patient-specific considerations for the optimal use of these strategies as well as options for alternative transplant approaches. He will also touch on emerging data regarding CAR T therapy in FL.

Chair:

Caron A. Jacobson, MD
Dana Faber Cancer Institute
Boston, MA

Speakers:

Jeff P. Sharman, MD
Willamette Valley Cancer Institute
Eugene, OR
Targeting CD20: Teaching an Old Dog New Tricks

Caron A. Jacobson, MD
Dana Faber Cancer Institute
Boston, MA
Pushing the Pace with Novel Agents

Ajay K. Gopal, MD
Seattle Cancer Care Alliance
Seattle, WA
Where Does Transplant Fit in the Age of Targeted Therapies?

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Myelodysplastic Syndromes: From Mild-Mannered to Lurking Leukemia


Session Offered Twice
Sunday, December 8, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, Hall E1, Level 2
Monday, December 9, 2019
2:45 p.m. - 4:15 p.m.

Orange County Convention Center, Hall E2, Level 2

Myelodysplastic Syndromes (MDS) are challenging clonal hematopoietic neoplasms, with respect to a complex disease biology, an older patient population in whom maintenance of quality of life and minimization of treatment side effects must be balanced with drug efficacy, and a limited arsenal of available treatment options. The therapeutic landscape is changing rapidly, though, reflecting the improved understand of the processes driving MDS.

Dr. Mikkael Sekeres will address “risk” as a default staging system in MDS. He will then cover established and new therapies for lower-risk MDS patients with isolated cytopenias or multiple affected cell lines, including defining responses to those therapies that are clinically meaningful.

Dr. Rena Buckstein will discuss the clinical challenges of predicting survival, toxicity and drug tolerability in the older patient population that constitutes MDS. She will summarize the evidence that supports the incorporation of frailty, disability and comorbidity into existing prognostic models and review available indices for use. Dr. Buckstein will provide recommendations for incorporating these in the clinic routinely and highlight areas for future research.

Dr. Guillermo Sanz will address the benefits and limitations of treatment alternatives for higher-risk patients with MDS, including hypomethylating agents and allogeneic hematopoietic cell transplantation. He will summarize the results of recent clinical trials with novel drugs and combinations in this setting and will highlight the potential improvement in outcomes that could result from our better understanding of the molecular and immunological bases of MDS.

Chair:

Mikkael A. Sekeres, MD, MS
Cleveland Clinic Taussig Cancer Institute
Cleveland, OH

Speakers:

Mikkael A. Sekeres, MD, MS
Cleveland Clinic Taussig Cancer Institute
Cleveland, OH
Lowering the Boom on Lower-Risk MDS

Rena J Buckstein, MD, FRCPC
Sunnybrook Odette Cancer Center
Toronto, ON, Canada
Integrating Patient-Centered Factors in the Risk Assessment of MDS

Guillermo F. Sanz, MD, PhD
Hospital Universitario y Politécnico La Fe
Valencia, Spain
In MDS, is Higher-Risk, Higher Reward?

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Myeloproliferative Neoplasms: Managing the Cup that Runneth Over


Session Offered Twice
Saturday, December 7, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, Chapin Theater (W320), Level 3
Saturday, December 7, 2019
4:00 p.m. - 5:30 p.m.

Orange County Convention Center, Chapin Theater (W320), Level 3

In his seminal review, Dr. William Dameshek speculated on a shared pathogenesis, and the likelihood of a "myelostimulatory factor" in the entities now known as Myeloproliferative Neoplasms. The discovery of JAK2 V617F ushered in a new era of understanding, and nearly 15 years later, the molecular landscape of the MPNs has been increasingly characterized. It is now understood that some patients are genetically predisposed to MPNs, or have hereditary, but non-clonal cytosis. However, establishing these diagnoses can be challenging. While the thrombotic tendency in the MPNs has been long recognized, defining key pathophysiological contributions remains an important goal. Recent work implicates JAK2 V617F as a prominent driver of the thrombotic tendency. Finally, while the JAK2 V617F discovery heralded development of JAK-inhibitors, a more complete understanding of the MPN pathogenesis has paved the way for development of novel therapies. The current landscape of MPN clinical trials is unprecedented, and hopefully, agents which clearly impact natural history will emerge.

Dr. Mary Frances McMullin will review the causes of hereditary erythrocytosis and thrombocytosis and distinguish from the genetic factors contributing to familial myeloproliferative disorders. The diagnostic pathways leading to diagnosis of hereditary disorders will be discussed.

Dr. Brady Stein will discuss the traditional and novel risk factors for MPN-thrombosis, in addition to contemporary risk classification. Treatment strategies to reduce risk for incident and recurrent thrombosis will be reviewed. Finally, an approach to management of special situations, including unusual site thrombosis, and MPN-bleeding will be discussed.

Within the context of current treatments that center on the JAK-STAT pathway, Dr. Aaron Gerds will review how emerging treatments are now reaching for new targets beyond JAK-STAT based on an ever-increasing understanding of the complex pathobiology of Ph-negative MPNs.

Chair:

Brady Lee Stein, MD
Northwestern University
Chicago, IL

Speakers:

Mary Frances Frances McMullin, MD,FRCPath,FRCP
Queens University
Belfast, United Kingdom
Diagnostic Workflow for Hereditary Erythrocytosis and Thrombocytosis

Brady Lee Stein, MD
Northwestern University
Chicago, IL
From Budd-Chiari to Acquired von Willebrand Disease: Thrombosis and Bleeding Risk in MPN

Aaron T. Gerds, MD, MS
Cleveland Clinic Taussig Cancer Institute
Cleveland, OH
Beyond JAK-STAT: Novel Therapeutic Targets in Ph-negative MPN

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Patients, Borders, Money, and Mission: A Global Perspective of Chronic Myeloid Leukemia


Session Offered Twice
Saturday, December 7, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, W315, Level 3
Saturday, December 7, 2019
2:00 p.m. - 3:30 p.m.

Orange County Convention Center, Sunburst Room (W340)

With the easy availability of first, second, and third generation tyrosine kinase inhibitors directed against the bcr/abl gene, the management of the majority of patients of CML in the chronic phase in the developed countries is pretty much ‘cut and dried’. However, for the huge number of patients in the resource-poor countries, optimal management poses several challenges. This session will focus on highlighting some of these challenges and discuss unique issues related to disease diagnosis, optimal management and monitoring, and issues related to making even the first generation TKI available to a section of patients.

Dr. Gary Lyman will discuss issues related to the introduction of generic imatinib on prescribing patterns, costs, and outcomes for patients with CML, including implications for care as second generation TKI’s become available as generics.

Dr. Hemant Malhotra, through a case-based discussion, will focus on disease characteristics in resource-poor countries, the availability and use of generic imatinib, the challenges with monitoring of CML and the use of some low-cost indigenous interventions for patients who have a sub-optimal response to imatinib and are not candidates for either second or third gen TKIs or Allo SCT.

Dr. Jerald Radich will then discuss the problem of bcr/abl monitoring in areas of the world where there are a large number of CML patients but with no/minimal laboratory facilities for RT-PCR testing. Dr. Radich will highlight innovative ways and means for testing and transporting blood samples which may be applicable and well suited to these under privileged regions of the world.

Finally, in the last talk, Ms. Pat Gracia-Gonzalez will highlight the problem of non-availability of TKI and even basic CML diagnostic facilities in resource-poor countries and the incredible efforts made by the MAX foundation to address some of these issue.

Chair:

Hemant Malhotra, MD,FRCP
Mahatma Gandhi Medical College Hospital
Jaipur, India

Speakers:

Gary H. Lyman, MD
Fred Hutchinson Cancer Research Center
Seattle, WA
The US Experience with Generic Imatinib in CML: Did Cost Predictions Meet Reality?

Jerald P. Radich, MD
Fred Hutchinson Cancer Research Center
Seattle, WA
Meeting the Needs of CML Patients in Resource-Poor Countries: a Roundtable Discussion

Hemant Malhotra, MD,FRCP
Mahatma Gandhi Medical College Hospital
Jaipur, India
Meeting the Needs of CML Patients in Resource-Poor Countries: a Roundtable Discussion

Pat Garcia-Gonzalez
The Max Foundation
Seattle, WA
Meeting the Needs of CML Patients in Resource-Poor Countries: a Roundtable Discussion

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Response Comes of Age in Chronic Lymphocytic Leukemia


Session Offered Twice
Sunday, December 8, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, Hall E1, Level 2
Monday, December 9, 2019
10:30 a.m. - 12:00 p.m.

Orange County Convention Center, Hall E2, Level 2

The dramatically increasing knowledge about pathogenesis, genetic drivers and resistance mechanisms as well as the availability of targeted agents in all lines of therapy have major impact on the complexity of CLL management. Although we have gained a wealth of knowledge from recent advances in the genomic characterization of cancer, the linking of genetic features of individual cancers with their phenotype has been thus far largely lacking.

Dr. Cathy Wu will present recent integrative analyses of genetic data, clinical information, and growth dynamics of CLL. These studies provide a conceptual and quantitative framework of cancer growth observed directly from human patients, which provides understanding of the vast variation in the clinical behavior of CLL. In parallel to the increasing knowledge of genetic features initial therapy of CLL has changed dramatically over the past few years with introduction of targeted therapies for this disease. Definitive trials of targeted agents versus chemoimmunotherapy have solidified targeted therapies as standard of care for most patients with treatment-naïve disease.

During her talk, Dr. Jennifer Woyach will discuss the Phase III trials that have led to the current standard of care in this disease as well as ongoing studies that are poised to take initial treatment of CLL to the next level. Continuous treatment versus fixed duration therapy of monotherapies and combinations of targeted agents are treatment options in relapsed CLL.

Dr. Barbara Eichhorst will discuss during her talk the pros and cons of different treatment options by highlighting the aspects of undetectable minimal residual disease and discontinuation of therapy.

Chair:

Barbara F. Eichhorst, MD
University of Cologne
Cologne, Germany

Speakers:

Catherine J. Wu, MD
Dana-Farber Cancer Institute
Boston, MA
Clonal Dynamics in CLL

Jennifer Woyach, MD
The Ohio State University
Columbus, OH
Treatment-naive CLL: Lessons from the phase III and phase II combo trials

Barbara F. Eichhorst, MD
University of Cologne
Cologne, Germany
Relapsed disease, discontinuation, and MRD

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Spoiled for Choice: Donor Selection for Allogeneic Stem Cell Transplantation


Session Offered Twice
Saturday, December 7, 2019
4:00 p.m. - 5:30 p.m.

Orange County Convention Center, Hall E1, Level 2
Sunday, December 8, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, W304, Level 3

Dr. Leo Luznik will discuss recent emergence of haploidentical transplantation as a viable option for patients with hematologic malignancies in need of allogeneic stem cell transplant.  He will summarize recent wealth of clinical data utilizing haplo HSCT with modern GVHD prevention strategies and how to integrate them in clinical decision making.  Recent biological advances on the biology of relapse and integration of novel agents after haplo HSCT to deal with disease recurrence will be also discussed

Dr. Annalisa Ruggeri will review recent expirence and state of the art in the field of allogeneic stem cell transplantation using cord blood. She will review recent data from large registries summarizing outcomes for adult and pediatric patients receiving cord blood transplant for patients with hematological malignancies and non-malignant hematological disorders.  The emerging results with new strategies for ex vivo expansion of cord blood and advantages associated with this approach will be also reviewed.

Dr. Katharina Fleischauer will summarize recent clinical advances using unrelated donors. She will summarize the available clinical evidence and discuss optimal selection of matched unrelated donors. New insights in the role of functional HLA matching in unrelated donor selection will be also presented including the relevant biology-driven algorithms.

Chair:

Leo Luznik, MD
Johns Hopkins University
Baltimore, MD

Speakers:

Leo Luznik, MD
Johns Hopkins University
Baltimore, MD
Emerging Role of Haploidentical Stem Cell Transplantation

Annalisa Ruggeri, MD
Hopital Saint Antoine
Paris, France
Optimizing Cord Blood Selection

Katharina Fleischhauer, MD
University Hospital Essen
Essen, Germany
Donor Selection for Matched Unrelated Donor Beyond HLA

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Therapy of Acute Myeloid Leukemia: Adapting to Change


Session Offered Twice
Sunday, December 8, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, Chapin Theater (W320), Level 3
Sunday, December 8, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, Chapin Theater (W320), Level 3

The recent approval of multiple novel and targeted therapeutics offers new hope and increasingly effective treatment options for patients with acute myeloid leukemia (AML). Long awaited clinical progress includes the development and approval of molecularly targeted, small molecule, and combination treatment approaches. This session will focus on the clinical management of AML in this new era of precision medicine, summarizing available evidence and highlighting optimal strategies for treatment and management.

Dr. Catherine Smith will discuss clinical advances in the care of patients with FLT3 mutations.  She will evaluate the recent FDA approvals and provide guidance for current treatment algorithms, review the status of key ongoing clinical trials, and emphasize key areas of ongoing translational research.

Dr. Courtney DiNardo will summarize the current treatment landscape of AML and discuss novel compounds under clinical development.  She will review the importance of a comprehensive genomic assessment and consider available treatment strategies particularly for patients considered inappropriate or refractory to standard intensive therapies.

Dr. Sylvie Freeman will examine the available approaches and the clinical and translational implications of minimal residual disease (MRD) assessments in AML.  She will review how to define MRD, how and when to assess for MRD, and whether MRD measurements should be used to drive treatment decisions.

Chair:

Courtney D. DiNardo, MD,MSc
University of Texas MD Anderson Cancer Center
Houston, TX

Speakers:

Catherine C. Smith, MD
University of California - San Francisco
San Francisco, CA
The Growing Landscape of FLT3 Inhibition in AML

Courtney D. DiNardo, MD,MSc
University of Texas MD Anderson Cancer Center
Houston, TX
Single-Agent and Combination Biologics

Sylvie D. Freeman, MBChB, DPhil
University of Birmingham
Birmingham, United Kingdom
MRD Evaluation of AML in Clinical Practice: Are We There Yet?

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Why Patients Fail After Allogeneic Stem Cell Transplantation


Session Offered Twice
Sunday, December 8, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, Valencia D (W415D), Level 4
Monday, December 9, 2019
7:00 a.m. - 8:30 a.m.

Orange County Convention Center, Tangerine 1 (WF1), Level 2

Even if the majority of patients are cured after allogeneic stem cell transplantation a substantial number will fail due to relapse or non-relapse mortality. This session will focus on new insights into biological mechanisms of tumor escape after transplantation as well as on the  impact of minimal measurable disease detection on outcome and how this insights and developments can be used in clinical practice. Lastly, causes of late non-relapse mortality and risk-based anticipatory intervention strategies will be presented

Dr. Luca Vago will present the most recent discoveries in tumor escape by impaired leukemia cell recognition such as HLA loss and different immune-escape mechanisms such as inhibitory immune–checkpoint molecules or enzyme and cytokine mediated immunosuppression. He will also address the role of clonal evolution and based thereon he will present clinical strategies to circumvent immune escape 

Dr. Jacqueline Cloos will discuss the increasing importance of minimal measureable disease detection prior and after stem cell transplantation. She will present the pros and cons of different MRD methods such as multicolor flow cytometry, PCR techniques and NGS and present options  how MRD detection can be used into a personalized relapse prevention strategy.

Dr. Smita Bhatia will present the risk and causes for late mortality other than relapse after stem cell transplantation such as secondary malignancies, chronic Graft-versus Host disease, infection, cardiopulmonary late effects or metabolic syndrome. She will also present recommendation how to monitor this patient after transplantation and provide risk based anticipatory intervention strategies to reduce late mortality

Chair:

Nicolaus Kroeger, MD
University Hospital Eppendorf
Hamburg, Germany

Speakers:

Luca Vago, MD, PhD
San Raffaele Scientific Institute
Milano, Italy
Immune Escape and Clonal Evolution

Jacqueline Cloos, PhD
VU University Medical Center
Amsterdam, Netherlands
Minimal Residual Disease and Stem Cell Transplantation Outcomes

Smita Bhatia, MD,MPH
University of Alabama at Birmingham
Birmingham, AL
Late Mortality without Relapse

Sessions on Non-Malignant Hematology

Balancing the Scales: Management of Patients at Risk of Bleeding and Clotting in the Acute Care Setting


Session Offered Twice
Sunday, December 8, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, W311, Level 3
Monday, December 9, 2019
2:45 p.m. - 4:15 p.m.

Orange County Convention Center, W308, Level 3

Managing patients with routine bleeding or clotting abnormalities can be difficult. Advances in medicine and technology present clinicians with even more complex and challenging situations than in the past. Often rapid decision making is required for patients with acute thrombosis or bleeding. This session will focus on extreme cases of bleeding or clotting for which limited data are available to guide the clinician.

Dr. Jean M. Connors will discuss the management of clotting and bleeding in patients with cancer. The approach to patients that have recurrent thrombosis despite adequate anticoagulation and those that require anticoagulation despite increased risk of bleeding will be reviewed.

Dr. Flora Peyvandi will review the management of acquired bleeding disorders. While acquired FVIII deficiency is rare, acquired deficiencies of other coagulation proteins such as FVII, FX, and FXIII are encountered even less frequently. The diagnosis and management of these extremely rare acquired factor deficiencies will be covered.

Dr. Frank W.G. Leebeek will present the signs and symptoms of bleeding in patients supported with left ventricular assist devices, describing the epidemiology, pathophysiology and management of bleeding in these patients in the acute care setting.

Chair:

Jean M. Connors, MD
Brigham & Women's Hospital/Dana Farber Cancer Institute
Boston, MA

Speakers:

Jean M. Connors, MD
Brigham & Women's Hospital/Dana Farber Cancer Institute
Boston, MA
Managing the Competing Risks of Thrombosis, Bleeding, and Anticoagulation in Patients with Malignancy

Flora Peyvandi
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Milan, Italy
Management of Rare Acquired Bleeding Disorders

Frank W.G. Leebeek, MD, PhD
Erasmus University Medical Center
Rotterdam, Netherlands
Management of Bleeding in Critical Care Setting

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Bone Marrow Failure and Clonal Evolution


Session Offered Twice
Monday, December 9, 2019
7:00 a.m. - 8:30 a.m.

Orange County Convention Center, W331, Level 3
Monday, December 9, 2019
2:45 p.m. - 4:15 p.m.

Orange County Convention Center, W331, Level 3

Myelodysplastic syndromes (MDS) are comprised of a heterogenous group of disorders characterized by clonal hematopoiesis with a propensity to evolve into acute myeloid leukemia.  MDS presenting in children and young adults is associated with clinically and biologically distinct features from MDS arising in older adults.  MDS presenting in children and young adults is associated with a higher likelihood of an underlying genetic predisposition; however genetic predisposition is increasingly recognized in a subset of older adults.  In this session, we will discuss genetic syndromes that increase susceptibility to MDS. 

Dr. Akiko Shimamura will discuss when  genetic susceptibility should be considered in children and in adults presenting for the first time with MDS, considering diagnostic strategies and implications of specific diagnoses.  

Dr. Stella Davies will then discuss strategies for screening and treatment of MDS in the setting of a known susceptibility. Different genetic syndromes provide specific challenges for screening, from those with high risk in which the need for annual screening is pressing, to disorders in which risk is moderate and may occur later in life, making the value of screening unclear.

Dr. Maciejewski will lastly discuss the clinical challenge of differentiating between aplastic anemia and hypocellular MDS.  Dr Maciejewski will discuss mechanisms of initiation and evolution of hypocellular MDS and the similarities and differences in genetic and immune changes in the two conditions, and the importance of this knowledge in diagnostic and treatment decisions.

Chair:

Stella M. Davies, PhD, MBBS, MRCP
Cincinnati Children's Hospital
Cincinnati, OH

Speakers:

Stella M. Davies, PhD, MBBS, MRCP
Cincinnati Children's Hospital
Cincinnati, OH
Monitoring and Treatment for MDS in Genetically Susceptible Persons

Akiko Shimamura, MD, PhD
Boston Children's Hospital
Boston, MA
Genetic predisposition to MDS: Diagnosis and management

Jaroslaw P. Maciejewski, PhD, MD, FACP
Taussig Cancer Center
Cleveland, OH
Diagnosis of Bone Marrow Failure Versus Hypocellular MDS in Older Adults

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Coagulation Conundrum Roundtable: Case-based Discussion on the Implications of Exogenous Estrogens in Hemostasis and Thrombosis


Session Offered Twice
Sunday, December 8, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, W311, Level 3
Monday, December 9, 2019
10:30 a.m. - 12:00 p.m.

Orange County Convention Center, W314, Level 3

Women of childbearing age with either a congenital bleeding disorder or thrombophilia are faced with several health problems related to hemostasis and thrombosis. These include heavy menstrual bleeding and postpartum hemorrhage in women with congenital bleeding disorders, and an increased risk of thrombosis while using exogenous estrogens in women with congenital thrombophilia. In this session, two clinical experts will discuss such scenario’s in two patients, and will focus on the following questions:

  1. How Do You Manage Contraception and Pregnancy in Patients with Congenital Bleeding Disorders?
  2. IVF and Thrombophilia: Should We Anticoagulate?

Although clinical data are limited and randomized trials are rare, for each of these scenarios both speakers shall provide the most current data and treatment guidelines, identifying gaps and future approaches to management.

Dr. Audra James will provide the Obstetricians View on each scenario.

Dr. Margaret Ragni will provide the Hematologists View on each scenario

Chair:

Saskia Middeldorp, MD, PhD
University of Amsterdam
Amsterdam, Netherlands

Speakers:

Andra H. James, MD,MPH
Duke University
Durham, NC
The Obstetricians View

Margaret V. Ragni, MD, MPH
University of Pittsburgh
Pittsburgh, PA
The Hematologists View

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Combined Basic Science and Education Session on Cancer-Associated Thrombosis


Session Offered Twice
Saturday, December 7, 2019
2:00 p.m. - 3:30 p.m.

Orange County Convention Center, Hall E1, Level 2
Monday, December 9, 2019
7:00 a.m. - 8:30 a.m.

Orange County Convention Center, Hall E1, Level 2

Dr. Marc Carrier will review the new data for primary thromboprophylaxis in ambulatory cancer patients and discuss the challenges in the management of cancer-associated thrombosis.

Dr. Michael B. Streiff will discuss the challenges of diagnosing venous thromboembolism in cancer patients. He will review the evidence on the use of D-dimer and clinical prediction rules in the diagnosis of cancer-associated thrombosis.

Dr. Katsue Suzuki-Inoue will discuss a role of platelets in cancer-associated thrombosis focusing on a platelet activation receptor, CLEC-2 and its ligand podoplanin on the surface of a certain types of cancer cells.

Dr. Nigel Mackman will discuss the roles of tumor-derived, tissue factor-positive extracellular vesicles, neutrophils and neutrophil extracellular traps in venous thrombosis in mice bearing human pancreatic tumors.

Chair:

Marc Carrier, MD
University of Ottawa
Ottawa, Canada

Speakers:

Marc Carrier, MD
University of Ottawa
Ottawa, Canada
Update from the Clinic: What's New in the Treatment of Cancer-Associated Thrombosis?

Casey L. O'Connell, MD
University of Southern California
Los Angeles, CA
Update from the Clinic: What's New in the Diagnosis of Cancer-Associated Thrombosis?

Katsue Suzuki-Inoue, MD, PhD
University of Yamanashi
Chuo, Japan
Update from the Lab: What's New in our Understanding of the Mechanism of Cancer Associated Thrombosis?

Nigel Mackman, PhD
University of North Carolina at Chapel Hill
Chapel Hill, NC
Update from the Lab: Analysis of Mechanistic Studies of Pathways of Cancer-Associated Thrombosis using Mouse Models

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DOACS in the Real World


Session Offered Twice
Saturday, December 7, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, W311, Level 3
Sunday, December 8, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, W311, Level 3

Direct oral anticoagulants (DOACs) are increasingly used for prevention and treatment of thromboembolism (TE). However, clinicians frequently encounter scenarios for which there is uncertainty about the optimal use of DOACs and management of complications. This session will address some of these challenges encountered during daily practice.

DOACs are currently approved for doses based on clinical trials for prophylaxis and therapeutic indications. However, there are clinical conditions that may benefit with lower doses for a variety of reasons. Dr. Beverly Hunt will address some of these conditions that might benefit with low dose DOACs.

Routine laboratory monitoring is not required for DOACs. However, with increased experience of DOACs use in real-world, there are some clinical scenarios where it might be useful to know (a). DOACs’ actual levels for their efficacy (e.g., occurrence of TE events on DOACs, extremes of body weights) or (b). rough estimate of DOAC presence in patients with major bleeding or requiring emergent surgery for guiding the use of specific reversal/non-specific hemostatic agents. Dr. Ravindra Sarode will cover laboratory testing for DOACs.

Although DOACs reduce the incidence of major bleeding, it remains the main complication of therapy. Specific reversal agents for DOACSs are available, however, their implementation and use can pose challenges for practicing clinicians. There are limited data on the use of non-specific hemostatic agents’ in this setting. Dr. Deborah Siegal will cover what we have learned about DOAC reversal and provide an approach to management of DOAC-related bleeding.

Chair:

Ravindra Sarode, MD
UT Southwestern Medical Center
Dallas, TX

Speakers:

Beverley J. Hunt
Guy's & St Thomas' NHS foundation Trust
London, United Kingdom
Is there a Role for Low Dose DOACs as Prophylaxis?

Ravindra Sarode, MD
UT Southwestern Medical Center
Dallas, TX
DOAC Monitoring: What tests are available to guide us?

Deborah M Siegal, MD MSc FRCPC
McMaster University
Hamilton, ON, CAN
What We Have Learned About DOAC Reversal.

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Inflammation and Hematopoiesis: The Impact of Inflammation on the Bone Marrow Microenvironment


Session Offered Twice
Sunday, December 8, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, Sunburst Room (W340)
Monday, December 9, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, W315, Level 3

Inflammation has many beneficial roles in activating the immune system for defense or facilitating tissue repair, but it also shows detrimental effects if sustained chronically, i.e., might lead to HSPC damage as bone marrow failure or leukemia. This session will focus on causes and consequences of inflammation in the bone marrow and discuss potential treatment options.

This session will summarize the insights from using a genetic approach to studying patients with sterile systemic inflammatory diseases. Understanding pathogenesis led to novel treatments, several are now FDA approved and target inflammatory cytokine signaling pathways. A challenging area for the hematologist is the diagnosis and treatment of conditions with clinical and pathogenic overlap, such as hemophagocytic lymphohistiocytosis (HLH) with other inflammatory hyperferritinemic syndromes including macrophage activation syndrome (MAS). Novel insights into monogenic causes for HLH and MAS provide not only novel insights into pathogenesis but also novel treatment options.  

Dr. Rebekka Schneider will summarize mechanisms which lead to an inflammatory bone marrow microenvironment and discuss how this affects normal hematopoiesis. She will pay particular attention to the process of aging which is known to involve low-grade inflammation and is also associated with age related clonal hematopoiesis and potentially malignant transformation.

Dr. Chinthrajah will discuss eosinophilic inflammation in a case-based presentation and the role of new biologics and immune suppressants in the approach to treating systemic eosinophilic inflammation.

Dr. Tessa Andermann will present a case of a patient with steroid-refractory GVHD and will discuss the role of fecal microbiota transplantation in the treatment. She will further discuss probiotics, and prebiotics and the effect of the microbiome on hematopoiesis and hematologic malignancies.

Chair:

Rebekka K. Schneider, MD,PhD
Erasmus University Medical Center
Rotterdam, Netherlands

Speakers:

R Sharon Chinthrajah
Stanford University
Stanford, CA
Systemic Autoimmune Diseases - Lessons for the Practicing Hematologist

Rebekka K. Schneider, MD,PhD
Erasmus University Medical Center
Rotterdam, Netherlands
Inflammatory Bone Marrow Microenvironment

Tessa M. Andermann, MD, MPH
UNC Chapel Hill
Chapel Hill, NC
The Microbiome and its Role in Hematology

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IRON: How to Manage When There is Too Much or Too Little of It


Session Offered Twice
Sunday, December 8, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, W331, Level 3
Monday, December 9, 2019
10:30 a.m. - 12:00 p.m.

Orange County Convention Center, W331, Level 3

Iron is an essential element for human development and function; when deficient or in excess, the impact on health is profound. Limitations in measuring iron levels has prompted emergence of novel detection strategies. Iron repletion methods are evolving with new indications for and formulations of intravenous iron. Iron chelation for those with chronic transfusion-dependent anemia has dramatically improved life expectancy. This session will focus on advances in understanding iron metabolism, novel diagnostic tools for iron measurement and identification and management of iron deficiency and iron overload.

Dr. Michelle Zeller will present a 3-step approach to iron deficiency that includes identification, investigation and management of underlying etiology and iron-repletion. She will contrast absolute and functional iron deficiency. Dr. Zeller will provide an update on indications for and selection of intravenous iron in different patient populations and address the need for judicious use of red blood cell transfusion. She will briefly touch upon the importance of iron deficiency recognition and repletion as a pillar of Patient Blood Management.

Dr. Yelena Ginzburg will discuss recent advances in our understanding of iron metabolism regulation and crosstalk with erythropoiesis and how this information can be translated to the clinical setting. She will summarize current standard tools for identifying iron deficiency in anemic patients, especially those with chronic inflammatory conditions, and explore how novel markers, such as hepcidin and erythroferrone, may benefit the diagnostician. Dr. Ginzburg will also touch briefly on several clinical challenges, evaluate the available evidence to further their management, and explore areas of uncertainty.

Dr. Thomas Coates will discuss, prior to effective iron chelation, death from induced iron cardiomyopathy occurred in the second decade in patients with transfusion dependent chronic anemias. The revolution in understanding of iron metabolism, the ability to monitor iron loading in the liver, heart, pancreas and pituitary, and the availability of several effective iron chelators have dramatically improved survival and reduced morbidity from transfusion related iron overload. With significantly increased survival, new complications like malignant transformation due to prolonged exposure to iron need to be considered in development of long-term therapeutic strategies.

Chair:

Michelle P. Zeller, MD
McMaster University
Hamilton, ON, Canada

Speakers:

Michelle P. Zeller, MD
McMaster University
Hamilton, ON, Canada
Management of Iron Deficiency

Yelena Ginzburg, MD
Mount Sinai School of Medicine
New York, NY
New Diagnostic Tools for Iron Deficiency

Thomas Coates, MD
University of Southern California Keck School of Medicine
Los Angeles, CA
Iron Overload in Transfusion-Dependent Patients

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Management of Sickle Cell Disease Complications Beyond Acute Chest


Session Offered Twice
Saturday, December 7, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, Hall E2, Level 2
Monday, December 9, 2019
2:45 p.m. - 4:15 p.m.

Orange County Convention Center, Tangerine 1 (WF1), Level 2

Evidence-based clinical care for sickle cell disease (SCD) has focused on the prevention and treatment of  infections, acute pain, acute chest syndrome and central nervous system complications. As survival in the pediatric age group improves, this clinical focus has broadened to include complications and conditions that have been under-addressed in large clinical trials although associated with significant morbidity and mortality.  In this session, through clinical case-focused discussion, we address renal complications, avascular necrosis (AVN) and complications associated with pregnancy.

Dr. Santosh Saraf will address acute and chronic renal complications of SCD.  The renal system is among the most commonly affected organ systems and is associated with increased morbidity and early mortality.  Dr. Saraf will discuss the clinical significance, the pathophysiology, and the evaluation and management approaches for kidney disease in patients with SCD.

Dr. Oyebimpe Adesina will discuss the evaluation and management of AVN.  AVN causes progressive bone and joint disease that can be associated with significant physical limitations and chronic pain. Dr. Adesina will address the importance of screening for AVN, issues related to hydroxyurea use, management approaches including core decompression and total hip replacement and perioperative care. 

Dr. Kim Smith-Whitley will focus on the complications of pregnancy in women with SCD.  Pregnancy-related complications are multifactorial and lead to significant morbidity and mortality for both mother and child.  Dr. Smith-Whitley will summarize these complications and will address selective and prophylactic transfusions, management approaches including the implementation of a systematic approach to care with a comprehensive, multidisciplinary team and research gaps.

Chair:

Kim Smith-Whitley, MD
Children's Hospital of Philadelphia
Philadelphia, PA

Speakers:

Oyebimpe O. Adesina, MD,MS
Seattle Cancer Care Alliance
Seattle, WA
Osteonecrosis in sickle cell disease: an update on risk factors and therapeutic interventions

Santosh L. Saraf, MD
University of Illinois at Chicago
Chicago, IL
Management of Renal Complications in SCD

Kim Smith-Whitley, MD
Children's Hospital of Philadelphia
Philadelphia, PA
Pregnancy-Related Complications

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New Diagnostic and Treatment Strategies for Antiphospholipid Syndrome


Session Offered Twice
Sunday, December 8, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, Chapin Theater (W320), Level 3
Monday, December 9, 2019
7:00 a.m. - 8:30 a.m.

Orange County Convention Center, Hall E2, Level 2

The antiphospholipid syndrome (APS)  is an autoimmune disorder that can result in venous and arterial thrombosis and pregnancy complications.  A catastrophic form of APS can present as a thrombotic microangiopathy affecting multiple organ systems. APS continues to be particularly challenging to diagnose, monitor and treat because its mechanistic basis is still being elucidated. Nevertheless, our APS patients require the best available treatments even before the final answers are in. This session will focus upon the progress which has been achieved in diagnosing and treating APS, including the potential of non-anticoagulant therapies.

Dr. Michelle Petri will discuss advances and refinements of diagnostic assays for APS. She will also review the contribution of complementopathies to the clinical manifestations of CAPS, and consider the currently available scoring systems for assessing the thrombotic risks to these patients.

Dr. Ware D. Branch will review the clinical and laboratory aspects of obstetric APS and also the current controversies regarding these.  He will also discuss how clinical and laboratory features may be used to stratify the risks of adverse pregnancy outcomes in women with APS, and review the current evidence on treatment of obstetric APS.

Dr. Doruk Erkan will address the spectrum of APS-related clinical manifestations. He will also discuss a wide variety of potential immunosuppressive approaches for treating the microvascular and non-thrombotic manifestations of non-obstetric APS for which traditional antithrombotic therapies tend to be ineffective.

Chair:

Jacob H. Rand, MD
Weill Cornell Medical College
New York, NY

Speakers:

Michelle Petri, MD, MPH
Johns Hopkins University School of Medicine
Baltimore, MD
Improvements in Diagnosis and Risk Assessment of Antiphospholipid Syndrome

David Ware Branch, MD
University of Utah Health
Salt Lake City, UT
What's New in Obstretric Antiphospholipid Syndrome?

Doruk Erkan, MD, MPH
Hospital For Special Surgery
New York, NY
Is There a Role for Immune Therapy in Antphospholipid Syndrome?

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Primary Immunodefiencies for the Hematologist: Finding the Needle in the Haystack


Session Offered Twice
Saturday, December 7, 2019
2:00 p.m. - 3:30 p.m.

Orange County Convention Center, Valencia D (W415D), Level 4
Sunday, December 8, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, W314, Level 3

Hematologists frequently are called upon to assess patients with symptoms that may arise from underlying immunodeficiency or immune dysregulation. While the genetic basis of these disorders remains unknown in many cases, increasingly an underlying genetic cause either due to novel genes or to hypomorphic mutations in known genes can be elucidated. This in turn may open the door for targeted or definitive treatment.

Dr. Luigi Notarangelo will discuss monogenic forms of primary immunodeficiency in which autoimmune cytopenias represent a prominent manifestation. He will discuss the pathophysiology of these disorders, and illustrate the results of targeted pharmacological interventions and of hematopoietic stem cell transplantation.

Dr. Charlotte Cunningham-Rundles will discuss the adult patient who has hypogammaglobulinemia, sometimes complicated by lymphadenopathy, splenomegaly and/or autoimmunity. The questions of how to evaluate these patients, what treatments might be applied, the genetic considerations, and when to consider the diagnosis of lymphoma, will be reviewed.

Dr. Sung-Yun Pai will discuss cellular treatment of monogenic disorders of immunity. She will discuss disorders for which allogeneic hematopoietic cell transplantation is standard, discuss challenges in transplantation of newly described disorders and particular patient populations, and touch on experimental emerging treatment with autologous gene therapy.

Chair:

Sung-Yun Pai, MD
Boston Children's Hospital
Boston, MA

Speakers:

Luigi Notarangelo, MD
National Institutes of Health
Bethesda, MD
Primary Immunodeficiency: Novel Genes and Unusual Presentations

Charlotte Cunningham-Rundles, MD, PhD
Mount Sinai School of Medicine
New York, NY
Common Variable Immunodeficiency: What's New in Diagnosis and Treatment

Sung-Yun Pai, MD
Boston Children's Hospital
Boston, MA
Treatment of Primary Immunodeficiency with Allogeneic Transplant and Gene Therapy

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Sickle Cell Disease in Young and Old: A Time for Re-Evaluation


Session Offered Twice
Saturday, December 7, 2019
2:00 p.m. - 3:30 p.m.

Orange County Convention Center, W304, Level 3
Sunday, December 8, 2019
9:30 a.m. - 11:00 a.m.

Orange County Convention Center, W304, Level 3

The care for patients with sickle cell disease has made significant advances in the last three decades and outlook has improved substantially for those with access to modern medical care. The majority of newborns in well-resourced countries will now survive to adulthood and overall median survival has recently been estimated to be in the late 50s and even the mid-to-late 60s in these countries. In contrast, more than 75 percent of newborns in sub-Saharan Africa do not even reach their fifth birthday. While prevention of complications and infection has been the mainstay for managing patients, the time has come for us to reevaluate our treatment strategy, to be more proactive in considering curative therapies early, before complications render the patients ineligible for these treatments. The longer survival forces us to rethink our treatment of the young, to address a most vulnerable period, and that is when children transition to adult care.

Dr. Mariane de Montalembert will discuss current strategies of comprehensive care for children in high-resource countries and compare with that accessible in developing ones. She will underline the need for a tight collaboration between proximity and expert health care providers, and the importance of increasing parents' and children' skills. 

Dr. Jane Hankins will discuss approaches to engage adolescents and young adults to empower them as advocates of their own disorder, and how to improve survival during the period of transition to adult care. She will review new care delivery models of engaging youth and maintaining their retention in adult care, as well as national benchmarks against which transition programs should be compared with.

Dr. Swee Lay Thein will discuss clinical challenges that are becoming increasingly common in the management of older patients with sickle cell disease, due to cumulative disease complications related to the chronic vasculopathy, in addition to those related to aging. She will summarize the available evidence, discuss optimal strategies for management, and highlight current challenges and areas of uncertainty

Chair:

Swee Lay Thein, DSc, MBBS
National Institutes of Health
Bethesda, MD

Speakers:

Mariane De Montalembert, MD
Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Obstetrical, Perinatal and Pediatric Epidemiology Research team (EPOPé), Inserm UMR 1153; Labex GR-Ex; Paris Descartes University
Paris, France
A Comprehensive Program of Care From Birth

Jane S. Hankins, MD, MS
St. Jude Children's Research Hospital
Memphis, TN
A Program of Transition to Adult Care

Swee Lay Thein, DSc, MBBS
The National Institutes of Health
Bethesda, MD
Optimal Disease Manage and Health Monitoring in Older Adults

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Transfusion Medicine: Optimizing Patient Blood Management (PBM)


Session Offered Twice
Monday, December 9, 2019
7:00 a.m. - 8:30 a.m.

Orange County Convention Center, W308, Level 3
Monday, December 9, 2019
4:30 p.m. - 6:00 p.m.

Orange County Convention Center, W308, Level 3

The term “patient blood management (PBM)” refers to the multi-disciplinary collaboration among health care providers (physicians, nurses, pharmacists, pump techs, and other physician extenders) to provide clinical patient management in various clinical scenarios without transfusion. This session will focus on strategies to avoid red blood cell (RBC) transfusions.

To be successful in minimizing or avoiding entirely the need for transfusion, a proactive approach is necessary. This is best illustrated by the presentation “Preoperative anemia screening clinics” by Dr. Yulia Lin; the single most important determinant for the need for RBC transfusions in surgical patients, is the preoperative RBC circulating volume; so that the identification and management of anemia patients preoperatively should be a cornerstone of PBM programs.

In the second presentation, Dr. Mike Murphy will review the current status of PBM as “best practices” or “standard of care” in patients receiving health care that will put them at risk for receiving transfusion therapy.

Finally, Dr. Lawrence Tim Goodnough will review his own program’s experience at Stanford University with the use of clinical decision support (CDS) to promote restrictive RBC transfusion practices in order to improve blood utilization.

Chair:

Lawrence Tim Goodnough, MD
Stanford University School of Medicine
Palo Alto, CA

Speakers:

Yulia Lin, MD
University of Toronto
Toronto, ON, Canada
Preoperative Anemia Screening Clinics

Michael F. Murphy
Oxford University Hospitals
Oxford, United Kingdom
Patient Blood Management as Standard of Care

Lawrence Tim Goodnough, MD
Stanford University School of Medicine
Palo Alto, CA
Clinical Decision Support to Improve Blood Utilization

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What's New in the Diagnosis and Management of von Willebrand Disease?


Session Offered Twice
Saturday, December 7, 2019
2:00 p.m. - 3:30 p.m.

Orange County Convention Center, Valencia BC (W415BC), Level 4
Sunday, December 8, 2019
7:30 a.m. - 9:00 a.m.

Orange County Convention Center, W224, Level 2

Although von Willebrand disease (VWD) is the most common inherited bleeding disorder, diagnosis and management of patients with VWD continues to present challenges. This session will offer clinical insights into the new diagnostic methods to identify VWD subtypes and advances in both treatment options and perioperative management of patients with VWD.

Dr. Sandra Haberichter will discuss advances in the diagnosis of von Willebrand disease. The central role of bleeding assessment tools in quantification of historical bleeding symptoms will be reviewed. The evolution of platelet-dependent assays of von Willebrand factor (VWF) function and the role of new assays in identification of VWD subtype will be highlighted. The utility of genetic testing in different VWD subtypes will be reviewed.

Dr. Pier Mannucci will summarize the most recent clinical advances in treatment of patients with VWD. The rationale and determinants of therapeutic efficacy, laboratory monitoring of treatment, and new therapeutic options for treatment will be outlined. Dr. Mannucci will address the critical issue of gastrointestinal bleeding in VWD patients and discuss optimal management strategies for this condition.

Dr. Michelle Lavin will discuss the unique clinical challenge associated with the surgical management of patients with VWD. Perioperative risk assessment, surgery in the era of recombinant VWF and the risks of Factor VIII accumulation will be reviewed in this case-based discussion of perioperative management.

Chair:

Sandra L. Haberichter, PhD
Medical College of Wisconsin
Milwaukee, WI

Speakers:

Sandra L. Haberichter, PhD
Medical College of Wisconsin
Milwaukee, WI
New Advances in the Diagnosis of vWD

Pier Mannuccio Mannucci, MD
IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation
Milano, Italy
What's New in Treatment of Von Willebrand Disease

Michelle Lavin, MD, PhD, FRCPath
Royal College of Surgeons in Ireland
Dublin, Ireland
Perioperative Management of patients with vWD

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Other Education Sessions

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