Education Spotlight Sessions

Balancing Bleeding and Clotting: Extended VTE Treatment for Whom and at What Dose?

Cancer-associated venous thromboembolism (VTE) is an important cause of morbidity and mortality in individuals with cancer. Prior studies have focused on the acute treatment of VTE and several modalities of treatment including low-molecular-weight heparins and direct oral anticoagulants (DOACs) have been intensively studied. These studies have typically addressed acute treatment periods up to six months after diagnosis of VTE. As long-term survivorship in the cancer community increases, clinicians need to better understand the treatment of VTE in the extended phase - after the initial 3-6 month period of anticoagulation. This vexing issue is addressed by several new studies, including randomized trials. This session will focus on providing clinically usable information on optimal anticoagulation strategies for treatment of VTE in the extended period after diagnosis. 

Dr. Marc Rodger will address the important issue of evidence-based determination regarding the need for continuing anticoagulation. Validated prognostic tools and approaches to identify 1) low VTE risk patients who can safely stop anticoagulants and 2) high bleeding risk patients who should stop anticoagulants will be reviewed.  He will address subgroups of the cancer population such as those with distal deep vein thrombosis (DVT) or isolated sub-segmental pulmonary embolism (PE) who have low risk of recurrent VTE and could potentially safely stop anticoagulation. He will also discuss clinical strategies on how to conduct an absolute risk-informed, preferences- and values-based discussion highlighting absolute long-term risks of recurrent VTE (and fatal PE) on/off anticoagulants and absolute long-term risks of major bleeding (and fatal bleeding) on and off anticoagulants.

Dr. Isabelle Mahe will address dose reduction strategies in extended treatment of cancer-associated VTE. She will review and discuss randomized trial-based evidence on the selection of patients for dose-reduced DOAC therapy, including impact on recurrent VTE and risk of major bleeding. She will discuss various clinical scenarios in the setting of long-term VTE treatment in individuals with cancer and nuanced, complex approaches to decision-making in this setting.

Chair:

Alok Khorana, MD
Cleveland Clinic
Cleveland, OH

Speakers:

Marc Rodger, MD, MSc
McGill University
Montreal, QC, Canada
VTE: Who Should Continue Anticoagulants Long-Term?

Isabelle Mahe, MD,PhD
Paris Cité University, Assistance Publique Hôpitaux de Paris
Paris, France
Anticoagulant Dose Reduction (who, how, and when)?

Bispecific Antibodies vs CAR T in Lymphoid Malignancies

Bispecific antibodies and chimeric antigen receptor T-cell therapies (CAR-T) are rapidly changing the treatment Paradigm of Relapse/Refractory Multiple Myeloma (MM). With the recent approvals of these treatment options in earlier lines, choosing the right patient for each therapy might be challenging. Likewise, bispecific antibodies and CAR-T therapy have both transformed the management of lymphoma, with multiple agents approved across different histologic subtypes.  Nonetheless, many unanswered questions remain about sequencing, optimal patient and/or product selection. We will discuss 4 cases (2 MM and 2 lymphoma) that highlight some of the challenges of real-world decision-making in this space.

Chair:

Yvonne Efebera, MD, MPH
OhioHealth
Columbus, OH

Speakers:

Eden Biltibo, MD, MS
Vanderbilt Health
Nashville, TN
In favor of Bispecific Antibody Therapy: Myeloma Perspective

Matthew Mei I, MD
City of Hope
Duarte, CA
In favor of Bispecific Antibody Therapy: Lymphoma Perspective

Current Perspectives on Evolving Classification of Myeloid and Lymphoid Neoplasms

The Society for Hematopathology (SH) and the European Association for Haematopathology (EA4HP) convened the Classification Advancement Meeting (CAM) for hematopoietic neoplasms in March 2026 in Chicago. The CAM is a joint effort between former members of the World Health Organization (WHO) 5th edition Classification and the International Consensus Classification (ICC) of hematopoietic neoplasms.

The goal of the CAM was to bring together expert hematopathologists, clinicians, and geneticists from around the world to discuss current issues and controversies in the classification of hematologic malignancies and to propose potential advancements to inform the forthcoming 6th edition of the WHO Classification of haematolymphoid tumours. The primary output of the CAM will be a series of peer-reviewed journal articles.

The presentations in this ASH Education Spotlight session reflect the areas of development and controversies from the personal perspectives of the invited speakers, based on discussions held during the CAM. These talks do not represent official conclusions or final recommendations of the CAM. As a field, we look forward to the final publication of these manuscripts and to the official 6th edition of the WHO classification in due course.

In this session, Dr. Amy DeZern will provide a clinical perspective and introduce the speakers. Dr. Laurence de Leval will share lymphoid perspectives, and Dr. Sanam Loghavi will share myeloid perspectives.

Chair:

Amy DeZern, MD, MHS
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore, MD

Speakers:

Sanam Loghavi, MD
MD Anderson Cancer Center
Houston, TX
Myeloid Updates

Laurence de Leval, MD, PhD
Lausanne University Hospital and Lausanne University
Lausanne, Vaud, Switzerland
Lymphoid Updates

Public Health & Hematology: Results and Lessons from the PEN-Plus Model of Care for Severe, Chronic Non-Communicable Diseases like Sickle Cell Disease in Resource-Poor Areas

Sickle Cell Disease has been declared a public health disorder by the World Health Organization (WHO). Estimates suggest that there are 8 million people in the world and 400,000 babies born every year, with sickle cell anemia, the most severe form of SCD. A public health approach to management of SCD is recommended in countries in Africa and Asia where the prevalence of disease is highest. This session will provide an overview of a public health strategy that has been developed, adopted and implemented as a regional health program by the World Health Organization Regional Office for Africa.

The Package of Essential Noncommunicable Disease Interventions–Plus (PEN-Plus) is a strategy designed to provide a clinical model for decentralized, life-saving, high quality longitudinal healthcare for people living with severe and chronic non-communicable diseases (NCDs) at first-level referral health facilities in rural and underserved communities. PEN-Plus focuses on three severe, chronic NCDs: sickle cell disease, rheumatic heart disease, and type 1 diabetes that cause an annual mortality of 30,000 of the world’s poorest children, adolescents, and young adults. The PEN-Plus Model aims to provide access to diagnosis and linkage to comprehensive, high-quality healthcare to reduce this mortality. The model poses a possible solution as a platform for SCD and other complex hematologic conditions.

Dr Emily Wroe will provide an overview of PEN-Plus and share clinical outcomes of 3,000 patients with sickle cell disease living in rural areas across 7 countries in the first years of PEN-Plus implementation and will discuss the training outcome and practical lessons learned in training healthcare providers, (non-hematology specialists), to care for sickle cell disease.

Dr Jane Hankins will discuss strategies to integrate newborn screening for sickle cell disease into the PEN-Plus model of care. At country level, a case study from Mozambique will share experience of partnerships with initiatives including St Jude's Global Hematology, ASHs, Consortium of Newborn Screening in Africa (CONSA) and national plans. Furthermore, she will provide an outline on scaling up newborn screening for sickle cell disease on the global landscape

Chair:

Julie Makani, MD, PhD
Muhimbili University
Dar es Salaam, Tanzania

Speakers:

Emily Wroe, MD
Center for Integration Science, Brigham and Women's Hospital
Boston, MA
Introduction to the PEN-Plus SCD Model of Care and Outcomes From the First Years of Implementation

Jane Hankins, MD,MS
St Jude Children's Research Hospital
Memphis, TN
Integrating Newborn Screening for SCD by CONSA, St Jude's Global Hematology and Ministries of Health into PEN-Plus in LMICs and Rural Settings

Rebooting the Immune System with Cellular Therapies

Chair:

Natalie Wuliji, DO
Fred Hutchinson Cancer Center
Seattle, WA

Speakers:

George Georges, MD
Defining Immune Reset: Mechanisms, Immune Reconstitution, and Biomarkers from Auto-HCT and CAR T-cell Therapy

Natalie Wuliji, DO
Fred Hutchinson Cancer Center
Seattle, 
Cellular Therapies for Severe Autoimmune Disease: From Case Series to Multicenter Trials and Hematologic Applications

Splenectomy in Membrane Disorders and Enzymopathies: Who, When and How?

Red cell membrane defects and enzymopathies are a heterogeneous group of hemolytic disorders that can present at any age, with variable severity, and often with acute exacerbations in circumstances such as infections or pregnancy. Management includes supporting increased red cell production needs with folic acid supplementation, providing acute or chronic red blood cell transfusions for symptomatic anemia, more recent exploration of small molecule pyruvate kinase activators, hematopoietic stem cell transplant, and gene therapy. Additionally, splenectomy may increase the circulatory red cell lifespan, thereby lessening anemia and other side effects of hemolysis. This session focuses on identification of who, when, and how an individual patient may benefit from splenectomy and illustrates appropriate perioperative and long-term management of splenectomy to minimize complications.

Dr. Scott Peslak will discuss the indications, timing, and surgical approach to splenectomy in patients with hereditary red cell membrane disorders and enzymopathies, including hereditary spherocytosis and pyruvate kinase deficiency. He will review how patient selection should be guided by disease severity, transfusion dependence, quality-of-life impact, and symptomatic splenomegaly, while weighing the lifelong risks of post-splenectomy sepsis and thrombosis. He will discuss how to balance the advantages of splenectomy against non-surgical management options, including initiating transfusions or trialing emerging disease-directed therapies such as pyruvate kinase activators. Throughout, Dr. Peslak will emphasize an individualized, evidence-based framework for optimizing the timing of splenectomy to maximize hematologic benefit while minimizing long-term harm.

Dr. Lawrence Wolfe will explore the role of partial splenectomy, highlighting success rates with comparison to total splenectomy and the limited information about patients who persist with their partial spleens for years post-surgery. The preparation for splenectomy will then be discussed, including vaccination strategies for different age groups, proper pre-surgical counseling of risks and benefits, and expectations of the experience of laparoscopic and conventional splenectomy. Finally, post-splenectomy care will be discussed, including staying current with immunological information about ways to prevent overwhelming post-splenectomy infection and concerns about possible thrombosis immediately post-splenectomy and then throughout the remaining life.

Chair:

Melissa Rose, DO
Nationwide Children's/ The Ohio State University
Columbus, OH, 

Speakers:

Scott Alan Peslak I, MD,PhD
University of Pennsylvania Perelman School of Medicine
Philadelphia, PA, 
Indications and Timing of Splenectomy in Hereditary Hemolytic Anemia

Lawrence Wolfe
Donald and Barbara Zucker School of Medicine at Hofstra
Hempstead, NY
Techniques for Splenectomy and Partial Splenectomy and Peri-splenectomy Care