Education Spotlight Sessions

Program Co-Chairs:

Olatoyosi Odenike, MD, University of Chicago
Chicago, IL

David Garcia, , University of Washington
Seattle, WA

Bone Marrow Failure Syndromes: Diagnostic Principles in 2022

Sunday, December 11, 2022, 4:30 p.m. - 5:45 p.m.
Ernest N. Morial Convention Center, 260-262

Bone marrow failure syndromes are a collection of entities that have variable impact on hematopoietic lineages, risk of transformation to MDS or AML and extra-hematopoietic syndromic features.  In addition to classic histopathology and clinical features, many of these diseases can now be defined by molecular alterations. Despite these advances in genetics, these diseases continue to be challenging to diagnose considering this heterogeneity and at times even more difficult to clinically manage.  This is particularly true when deciding whether to move patients to bone marrow transplantation.  Overall, the complexity of these diseases suggests a multidisciplinary approach is the best strategy for patient management. 

Sara Lewis, a Genetic Counselor, will discuss the critical role of a genetic evaluation in patients with concern for bone marrow failure and how these findings may impact future clinical management.

Dr. Mark Fleming, a Hematopathologist, will then review the role of a thorough microscopic evaluation in both the initial evaluation of patients with concern for a bone marrow failure syndrome and in the assessment for disease progression.

Chair:

Jeffery Klco, MD, PhD
Saint Jude Children's Research Hospital
Memphis, TN

Speakers:

Sara Lewis, MS, CGC
St Jude Children's Research Hospital
Lakeland, TN
Role of Genetic Evaluation in the Diagnosis of Bone Marrow Failure Syndrome

Mark D. Fleming, MD, DPhil
Boston Children's Hospital
Boston, MA
Pathology vs molecular genetics: comprehensive microscopic evaluation will remain the essential initial step

Debate: Most/All Patients with Acquired (Immune) Thrombotic Thrombocytopenic Purpura Receive Caplacizumab

Monday, December 12, 2022, 10:30 a.m. - 11:45 a.m.
Ernest N. Morial Convention Center, 295-296

This ASH spotlight session will feature a debate discussing whether caplacizumab should be a component of the routine treatment of all patients with acute thrombotic thrombocytopenic purpura. Recently introduced, caplacizumab had a modest impact on disease in large clinical trials. Despite this, various guidelines and recommendation documents have suggested its routine use. However, persuasive arguments can be made both for and against its use, in light of its cost/ benefit analysis and its impact on long-term outcomes, particularly in light of other therapeutic advances in this area, including the widespread use of anti CD 20 monoclonal antibodies for patients presenting with TTP.

Chair:

Mark Crowther, MD
McMaster University
Hamilton, ON, Canada

Speakers:

Camila Masias, MD,MPH
Miami Cancer Institute
Miami, FL
FOR (All/most patients should receive caplacizumab)

George Goshua, MD,MSc
Yale University School of Medicine
New Haven, CT
AGAINST (most/all patients with Acquired TTP should receive caplacizumab)

Immunotherapies for myeloid neoplasms: are we ready for primetime?

Monday, December 12, 2022, 2:45 p.m. - 4:00 p.m.
Ernest N. Morial Convention Center, New Orleans Theater AB

While the U.S. Food and Drug Administration (FDA) has approved immunotherapies including monoclonal antibodies with/without drug conjugates, bispecific T-cell engager (BiTE), immune checkpoint inhibitors and chimeric antigen receptor T cells (CAR-T) for lymphoid neoplasms which have dramatically improved the survival of patients with lymphoma, acute lymphoblastic leukemia and multiple myeloma; approval of immunotherapies for myeloid malignancies has lagged. After the approval, withdrawal and eventual re-approval of the CD33 antibody-drug conjugate, gemtuzumab ozogamicin, for the treatment of CD33-positive acute myeloid leukemia (AML) in 2017 and the approval of the CD123- binding drug conjugate, tagraxofusp-erzs, for the treatment of the patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN) in 2018, no other immunotherapies have achieved regulatory approval for myeloid neoplasms. Until now, success in myeloid neoplasms has come from targeting mechanisms of survival and specific mutations. In this context, the promising data and novel approaches described in the past years lead us now to ask if immunotherapies for myeloid neoplasms are finally ready for prime time. This session will discuss the promising data from these novel approaches and explore the potential of immunotherapies in myeloid neoplasms. Dr. Sarit Assouline will discuss the potential of BiTEs, immune checkpoint molecules, macrophage checkpoint molecules for AML and high-risk MDS. Dr. Saar Gill will address the barriers of CAR-T therapy for high-grade myeloid neoplasms and provide strategies to overcome these barriers.

Chair:

Hongtao Liu, MD,PhD
The University of Chicago Medical Ctr.
Chicago, IL

Speakers:

Sarit Assouline
McGill University/Jewish General Hospital
Montreal, QC, Canada
BITEs, immune checkpoint molecules, macrophage checkpoint molecules for AML and high grade MDS-

Saar Gill, MD,PhD
University of Pennsylvania School of Medicine
Philadelphia, PA
CAR-T therapy for high grade myeloid neoplasms- what are the barriers and how do we overcome?

New Horizons for Histiocyte Disorders

Sunday, December 11, 2022, 4:30 p.m. - 5:45 p.m.
Ernest N. Morial Convention Center, 275-277

Histiocyte disorders are characterized by single or multi-organ infiltration of neoplastic myeloid-derived cells with diverse macrophage and dendritic cell phenotypes with an associated accumulation of inflammatory cells. These inflammatory myeloid neoplastic disorders, affecting both adults and children, are rare and heterogenous with over 100 subtypes described. The four most common histiocyte neoplasms are Langerhans cell histiocytosis, Erdheim-Chester disease, Rosai-Dorfman disease and juvenile xanthogranuloma. The identification of shared ERK activation and somatic mutations in MAPK pathways genes has resulted in better understanding of the pathophysiology of these previously clinically and morphologically linked disorders and has resulted in improved diagnostic tests and expanded treatment options for patients. Dr. Carl Allen will discuss the landscape of mutations found in histiocyte neoplasms. Dr. Eli Diamond will discuss targeted therapies for histiocyte disorders.

Chair:

Paul C. Hendrie, MD,PhD
Fred Hutchinson Cancer Center
Seattle, WA

Speakers:

Carl E. Allen, MD
Texas Children's Cancer Center
Houston, TX
Updates on Genetic Drivers of Histiocyte Disorders

Eli L Diamond, MD
Memorial Sloan Kettering Cancer Center
New York, NY
How and When to Incorporate Targeted Therapy into the Treatment of Histiocytic Disorders

Point/Counterpoint: The case for/against thrombophilia testing in many/most adults with unprovoked thrombosis.

Monday, December 12, 2022, 2:45 p.m. - 4:00 p.m.
Ernest N. Morial Convention Center, 288-290

The role of thrombophilia testing in clinical practice remains controversial. In the absence of clinical trials evaluating thrombophilia testing and its effect on decision-making and clinical outcomes, the utility of thrombophilia testing is largely guided by expert opinion. Thrombophilia testing is frequently requested and performed in patients with a family history of thrombosis, in patients with established thrombosis and in women with pregnancy complications. The merits and pitfalls of thrombophilia testing in these scenarios will be discussed and debated.

Chair:

Wendy Lim, MD,MSc
McMaster University
Hamilton, ON, Canada

Speakers:

Stephan Moll, MD
University of North Carolina School of Medicine
Chapel Hill, NC
Point/Counterpoint: There case FOR thrombophilia testing in many/most adults with unprovoked thrombosis.

Deborah M. Siegal, MD
Ottawa Hospital Research Institute
Ottawa, ON, Canada
Point/Counterpoint: There case AGAINST thrombophilia testing in many/most adults with unprovoked thrombosis

Survivorship in adult patients with lymphoma

Sunday, December 11, 2022, 4:30 p.m. - 5:45 p.m.
Ernest N. Morial Convention Center, Great Hall AD

Lymphoma patients are surviving their initial bout with cancer in increasing numbers. Long-term health has become an important consideration for patients. In this session, we will highlight some of the most recent developments in this area especially with new NCCN guidelines. Special focus will be on cardio-oncology, cardiovascular health for this patient population.  In addition, presenters will discuss surveillance for secondary malignancies and psychosocial outcomes in lymphoma survivors.

Chair:

Javid J. Moslehi, MD
University of California San Francisco
San Francisco, CA

Speakers:

Javid J. Moslehi, MD
University of California San Francisco
San Francisco, CA
Prevention, screening and treatment of treatment related cardiomyopathy

Carrie A. Thompson, MD
Mayo Clinic
Rochester, MN
Screening for Radiation and Chemotherapy Late Effects (except cardiac)

Underrepresented minorities in clinical trials for hematologic malignancies: what's the data on the data?

Monday, December 12, 2022, 10:30 a.m. - 11:45 a.m.
Ernest N. Morial Convention Center, R06-R09

The management of multiple myeloma, a condition 2-3 times more incident in Black than in White individuals, was revolutionized in the past 15 years by the development of a large number of new agents, longer, more complex and costly therapy. Therefore, multiple myeloma presents as excellent scenario to study disparities in clinical trial participation and outcomes. Although individuals of racial-ethnic minorities are under-represented in clinical trials for new drug registration in multiple myeloma, when enrolled their outcome is the same or even better than in other patient groups. This session will discuss available data on minority participation in myeloma trials, explore possible root causes and provide recommendations to assure representation of minority patients such as prospective enrollment goals and eligibility criteria which permit inclusion of real-world patients. Reforming the new drug development paradigm will allow for assessing both efficacy and toxicity of novel agents in an inclusive, real-world multiple myeloma patient population.

Chair:

Kenneth C. Anderson, MD
Dana-Farber Cancer Institute
Boston, MA

Speakers:

Luciano J. Megala Costa, MD,PhD
University of Alabama at Birmingham
Birmingham, AL
Discuss historical percentages of URM enrollment in clinical trials and theories for this data

Sikander Ailawadhi
Mayo Clinic
Jacksonville, FL
Discuss approaches to improve enrollment and outcomes

Rayne H. Rouce, MD
Baylor College of Medicine, Texas Children's Hospital
Houston, TX
Discuss approaches to increase the proportion of underrepresented minorities in the clinical investigator/clinical research pathway.