NEW ORLEANS — In summation to quality connected the latest successful objective attraction and cause development, immoderate eyebrow-raising findings that situation long-held but untested assumptions are promised from the yearly gathering of the American Society of Hematology.
The league starts successful New Orleans connected Saturday, but a illustration of what is to travel was fixed past week successful a preview media briefing, moderated by Mikkael A. Sekeres, MD, from the University of Miami Miller School of Medicine. Sekeres, who precocious authored a publication connected the FDA and however it regulates cause approvals, besides serves arsenic seat of the ASH Committee connected Communications.
"Feeding Our Patients Gruel"
Sekeres said that he's peculiarly excited astir a multicenter randomized proceedings showing that patients who person neutropenia aft a stem compartment transplant don't person to beryllium stuck eating a bland fare (Abstract 169).
"We for years person been fundamentally feeding our patients gruel successful the hospital, and these are folks who person to beryllium hospitalized for a stem compartment transplant oregon successful my lawsuit – I'm a leukemia specializer — for acute leukemia, for 4-6 weeks. The neutropenic fare consists of the blandest nutrient you tin imagine, with thing to truly spice it up."
He noted that a neutropenic fare is truthful unpalatable that household members often sneak nutrient into diligent rooms, and "for years we've ne'er seen adverse outcomes successful immoderate of those folks who alternatively of having mashed potatoes and oatmeal ate a corned beef sandwich for dinner."
Now, the results from this proceedings "actually springiness america licence to yet let patients to devour immoderate they want," helium said.
Practice-Changing Data
Another 2 presentations that ASH experts said are definite to alteration objective signifier see the uncovering that high-dose methotrexate does not trim the hazard for cardinal tense strategy (CNS) relapse successful children with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (Abstract 214), and a common-wisdom-defying survey showing that intensive chemotherapy successful an effort to execute remission earlier a stem compartment transplant successful adults with relapsed oregon refractory acute myeloid leukemia (AML) did not effect successful amended outcomes compared with sequential conditioning and contiguous transplant (Abstract 4).
Premature Aging successful HL Survivors
ASH President Jane N. Winter, MD, from the Feinberg School of Medicine astatine Northwestern University successful Chicago, who besides spoke astatine the briefing, highlighted a survey that followed big survivors of pediatric Hodgkin lymphoma. This study, from St. Jude Children's Research Hospital successful Memphis and the Wilmot Cancer Institute astatine the University of Rochester, New York, recovered that these big survivors are astatine importantly elevated hazard for epigenetic property acceleration accompanied by neurocognitive deficits erstwhile compared with controls.(Abstract 902)
"This is an country that is precise adjacent and beloved to my heart," she said. "Much of my vocation has focused connected reducing the therapy to trim the semipermanent consequences of treatments. Pediatricians person been precise overmuch wedded to precise intensive therapies and thin to incorporated radiation much commonly successful their attraction strategies for children than we bash successful adults."
Winter noted that though clinicians absorption chiefly connected the nexus betwixt mediastinal radiation and semipermanent adverse events specified arsenic breast cancer, "now we're shedding a airy connected the neurocognitive deficits, which I deliberation are underappreciated. Being capable to surface for this interaction of our attraction and possibly past make strategies to woody with it oregon forestall it volition person precise wide-ranging impact."
Inherited Thrombophilia and Miscarriage
Cynthia E. Dunbar, MD, main of the Translational Stem Cell Biology Branch astatine the National Heart, Lung and Blood Institute successful Bethesda, Maryland, who besides spoke astatine the briefing, said that 1 of the abstracts astir important to her signifier is simply a survey concerning pregnancy. It showed that low-molecular-weight heparin did not forestall miscarriage successful large women with confirmed inherited thrombophilia who had 2 oregon much anterior gestation losses compared with modular surveillance. (Abstract LBA-5).
"This is not my tract astatine all; connected the different hand, arsenic a hematologist and a woman, that's what my emails successful the mediate of the nighttime and my panicked telephone calls are often about. Once idiosyncratic has 1 miscarriage, particularly if they consciousness similar they're already implicit 30 and the timepiece is ticking, there's a immense accent and a immense magnitude of unit connected obstetricians to fundamentally enactment up for everything, benignant of a shotgun [approach]," she said.
Those workups whitethorn uncover familial mutations that are associated with mild elevations successful hazard for clotting, and arsenic a effect immoderate large women are enactment connected anticoagulation therapy, which tin origin complications for some gestation and delivery. The findings from this survey don't lick the occupation of spontaneous pregnancy loss but they astatine slightest regularisation retired inherited thrombophilia arsenic a preventable origin of miscarriages, Dunbar said.
Another perchance practice-changing abstract is simply a survey showing that successful younger adults with mantle compartment lymphoma, the summation of the Bruton's tyrosine kinase inhibitor ibrutinib (Imbruvica) to induction therapy and arsenic attraction with oregon without autologous stem compartment transplant had beardown efficacy and acceptable toxicity.(Abstract 1)
"The results amusement that the ibrutinib-containing regimen without transplant is astatine slightest arsenic bully arsenic the existent modular of attraction with transplant." Winter said. "Additional follow-up volition beryllium required to amusement definitively that an autotransplant is unnecessary if ibrutinib is included successful this attraction regimen."
Health Equity Challenges
In summation to the much objective abstracts, ASH 2022 volition diagnostic sessions connected addressing challenges successful wellness equity, including an abstract connected societal determinants of wellness and pulmonary embolism attraction and mortality (Abstract 140); the interaction of lab-based eligibility criteria by race/ethnicity successful objective trials for diffuse ample B-cell lymphoma (Abstract 850); associations betwixt non-European ancestry and debased socioeconomic presumption with the receipt of HLA-disparate allografts (Abstract 127); and an investigation of the usage worldwide of hematopoietic stem compartment transplantation for patients with acute myeloid leukemia (Abstract 3638).
Hybrid Meeting
All told, ASH 2022 volition diagnostic astir 5000 abstracts presented successful a hybrid unrecorded and virtual format. On-site attendees volition beryllium required to supply impervious of vaccination against COVID-19 and volition besides beryllium required to deterioration masks successful each nationalist areas.
American Society of Hematology (ASH) 2022 Annual Meeting & Exposition: December 10-13, 2022.
Neil Osterweil, an award-winning aesculapian journalist, is simply a long-standing and predominant contributor to Medscape.
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