This year’s ASH Annual Meeting and Exposition, taking place December 5-8 in Orlando, Florida, features a diverse lineup of educational activities, networking opportunities, and practice-changing science. ASH Clinical News spoke with the program co-chairs and several speakers for an exclusive look at highlighted sessions and what attendees can expect from the meeting.
Education Program Co-Chairs
David Steensma, MD
Dana-Farber Cancer Institute
Associate Professor of Medicine
Harvard Medical School
Barbara Konkle, MD
Professor of Medicine
Puget Sound Blood Center
In your opinion, what are the “can’t-miss” events attendees should put on their schedules?
Dr. Steensma: As someone who has long been interested in history and literature, one of the things I am most excited about at this year’s meeting is a Special-Interest Session on the symbolism of blood. We invited journalist Lawrence Hill, from the Canadian CNBC, to talk about the cultural implications of blood, blood as a symbol, and blood with respect to perception of race. Marc Kahn, MD, who was the lead medical consultant on the award-winning PBS series Red Gold: The Epic Story of Blood, will be introducing the session and discussing key historical milestones in the evolution of human understanding of blood. I am very excited about that session.
Dr. Konkle: I absolutely agree! Each attendee will have their own can’t-miss events, depending on their clinical practice or research focus and areas of interest, and further integration of the Scientific and Educational Program schedules provide many options throughout the meeting for all attendees. But I believe “The Epic Story of Blood” will be of interest to the entire hematology community.
How does this year’s Education Program differ from previous years?
Dr. Konkle: Each year the Education Program co-chairs and planning committee work to develop a program with content that will aid the clinician in keeping up-to-date on hematologic issues and help them with complex medical decision-making. We worked toward that goal again this year but opened up a few new areas.
Dr. Steensma: We want to avoid talking about the same things every year, so each year’s Education Program has a little bit of a different flavor, depending on what is currently happening in the field and the topics of previous years. I think some of the exciting things about this year’s program are the multiple sessions focusing on incorporating molecular testing into diagnosis and treatment plans for different diseases.
The “Palliative Care in Hematologic Malignancies” session is a new topic, and an important one. We normally think of palliative care in relation to patients with solid tumors, but many of our patients with hematologic malignancies could certainly benefit as well.
Another new session, “Patient-Reported Outcomes in Hematology,” will feature several speakers discussing both how to design patient-reported outcomes and how to use them in clinical trials and clinical practice. This type of data is collected from the patients themselves about their symptoms and experiences, which lets clinicians detect if a treatment is successful, not just through objective findings, but also whether it makes the patient feel better or worse.
There are also sessions on “Recent Advances in Histiocytic Neoplasms” and “Pediatric Hematologic Malignancies: Beyond Acute Lymphocytic Leukemia” that are new to the Education Program.
What were your goals in designing this year’s Education Program?
Dr. Steensma: We wanted to fill the Education Program with engaging and up-to-date content. We always want to have a very diverse mix of speakers – a good balance of speakers from different countries and institutions and from different generations – so the audience can hear new voices. We wanted to try some innovative material, and I think we managed to meet that goal; for instance, there is a Spotlight Session on bureaucracy in clinical trials and we have never before had a session on palliative care or patient-reported outcomes.
Dr. Konkle: My goals as co-chair were two-fold: first, to bring new or recently updated information to the attendees (in the areas of direct oral anticoagulants and new therapies and approaches for hemophilia, sickle cell disease, hemolytic anemias, and other benign hematologic conditions, for instance); second, to help practitioners manage both the common and rare conditions seen in hematologic consultations and assist them in making the complex medical decisions and recommendations required. So, accordingly, there are sessions on “Hemophagocytic Lymphohistiocytosis in Adults,” “Challenging Anticoagulation Scenarios,” and “Challenging Scenarios in Thrombosis” in this year’s program.
What are some of the special sessions designed for early-career hematologists/trainees? For educators?
Dr. Steensma: In addition to the special track for trainees and the Trainee Day at this year’s meeting, there are also special sessions for people who are just beginning their careers, like the “Junior Faculty Development Education Session” on understanding the basics of the academic job or “How to Get Published in a Peer-Reviewed Journal.”
Dr. Konkle: There are several sessions designed specifically for trainees and anyone interested in career development, but I also encourage trainees and early-career hematologists to take time, sit back, and just listen to the science and clinical breakthroughs. Allow yourself to be excited by it all.
For educators, in addition to the workshops for training program directors and hematology course directors, this year’s “Social Media for the Hematologist” session may be of interest.
Scientific Program Co-Chairs
Andrew W. Roberts, MBBS, PhD
Walter and Eliza Hall Institute of Medical Research
The Royal Melbourne Hospital
Akiko Shimamura, MD, PhD
Professor of Pediatrics/Hematology-Oncology
Adjunct Professor of Medicine/Hematology
University of Washington
Fred Hutchinson Cancer Research Center
In your opinion, what are the events and sessions in this year’s Scientific Program that attendees need to add to their agenda?
Dr. Shimamura: This year’s Special Scientific Symposia focus on the translation of cutting-edge scientific findings to clinical care. “The Special Symposium on Targeting the Epigenome,” for instance, will focus on recent insights into epigenetic mechanisms of malignant transformation and the development of epigenetic-directed therapeutics. The “Special Scientific Symposium on Genomically Engineered Stem Cells: A Brave New World for Therapeutics” will explore the exciting possibilities for the development of novel cellular therapies that genomic engineering of stem cells has opened up. I believe many of the general issues with developing and operationalizing individualized therapies are broadly applicable to non-malignant hematology, as well.
Dr. Roberts: The Ham-Wasserman, E. Donnall Thomas, and Ernest Beutler lectures are always must-sees for hematologists who enjoy hearing from pioneers about how the great advances in hematology came about. This year’s line-up is no different.
Which areas of research do you think will have the most exciting implications for clinical practice?
Dr. Roberts: As always, a number of practice-changing clinical trials will be reported in the Oral sessions, Plenary Scientific session, and Late-Breaking Abstract session.
Dr. Shimamura: The potential diagnostic and clinical implications of genome-wide analyses in guiding risk stratification and informing treatment decisions are vast. This technology is advancing at a rapid pace – leading to decreased costs and faster turnaround – and the implications cut across malignant and non-malignant hematology, as well as hematopoietic stem cell transplantation.
How does this year’s program differ from previous years?
Dr. Shimamura: A strong theme emerged while we were developing this year’s Scientific Program: Advances in genomics and genomic engineering are poised to change hematology science and practice. Many presentations will highlight the implications for basic mechanistic understanding of hematology, opportunities to develop novel therapeutics, and decision-making in clinical care.
Dr. Roberts: Also, our capacity to target epigenetic regulators with drugs and to alter the genetic makeup of primary human cells will be showcased in several areas.
What are some of the special sessions designed for early-career hematologists and trainees? For educators?
Dr. Shimamura: The Continuing Conversations with the Speakers series will provide attendees with the opportunity to meet with experts in the field for a small-group discussion. This format is designed to foster dialogue and discussion, rather than didactic lectures. The Scientific Spotlight Sessions, which open with a short presentation by two leading experts in the field followed by interactive discussions with the audience, are also designed to encourage in-depth dialogue about these topics.
Session Sneak Peek
Special Symposium on Quality: Exploring the Promise and the Pitfalls of Quality Measures and Pay-for-Performance
Saturday, December 5, 2015, 2:00 – 3:30 p.m.
While the trend of value-based reimbursements has been evolving over the past decade, the pace of change in the United States has accelerated since the introduction of the Patient Protection and Affordable Care Act. There is widespread agreement on the importance of measuring and optimizing the quality of medical care; however controversy exists around the best way to achieve this aim. Lisa K. Hicks, MD, MSc, a co-chair of the program, discussed the goals of this session with ASH Clinical News:
“Our aim is to provide an introduction and overview of quality metrics and pay-for-performance in health care, outlining the evidence on pay-for-performance – which remains mixed. There are several areas of quality that clinicians need to be knowledgeable of, including how the Center for Medicare & Medicaid Services’ (CMS) merit-based incentive payment system could affect their financial bottom line.
U.S. health care is undergoing a sea of change with regard to how hospitals and physicians are reimbursed. CMS is very committed to tying payment to the provision of higher quality care; this is a laudable goal that aims to reward institutions delivering high quality, while incentivizing others to improve.
Whether high-quality care can be accurately measured or whether tying reimbursement to quality metrics actually leads to improved outcomes is not entirely clear at this time. Notwithstanding some of the uncertainties, it is clear that over the next six years pay-for-performance will increasingly impact the practice and remuneration of physicians who provide care to Medicare and/or Medicaid patients. Indeed, by 2022 physicians could receive a negative or positive 9-percent payment adjustment, depending on how they perform on CMS’ merit-based incentive payment system.”
ASH/ASCP Summit on Myelodysplastic Syndromes: Diagnosis, Classification, and Clinical Care of MDS
Saturday, December 5, 2015, 4:00 – 5:30 p.m.
This session will review prognostic scoring systems used in myelodysplastic syndromes (MDS), including their use as default staging systems, the recent incorporation of molecular data into these systems, and how they are applied to make therapeutic decisions. ASH Clinical News Editor-in-Chief, Mikkael Sekeres, MD, MS, offered some insight into what the session will cover:
“This special session represents the culmination of four, intensive, regional education sessions on MDS we have held for approximately 200 people around the country. It has been a wonderful collaboration between ASH and the American Society of Clinical Pathology in which hematologists and pathologists have educated an audience of their peers in a collaborative teaching and learning model.
In this session, we will review the many prognostic scoring systems that take the place of a formal staging system in MDS; how to manage MDS patients with secondary disease or who have multiple comorbidities (both of which represent a particularly challenging patient population); and pathologic mimics of MDS (diseases that can resemble MDS at a cellular level).
MDS represents the most common myeloid malignancy in the United States, with at least 20,000 new diagnoses annually and tens of thousands of people living with the disease. Because MDS is such a heterogeneous disease that affects mainly older adults, it is challenging both to diagnose and to treat. In addition, it is easy to get tricked into treating a person who has cytopenias and is elderly, but does not formally carry an MDS diagnosis.
We will focus on distinguishing lower- from higher-risk MDS – in which life expectancy and treatment goals differ dramatically – and on special populations of patients who do not necessarily abide by standard treatment guidelines because of significant comorbidities that may limit treatment options, or with disease that results from treatment for other cancers.”
Featured Topic: Gene Therapy
Sunday, December 6, 2015, 11:15 a.m. – 12:30 p.m.
The two “Featured Topic” sessions at this year’s meeting will highlight research that was submitted as abstracts and presented predominantly as posters at the annual meeting. In this session, moderators Daniel E. Bauer, MD, PhD, and Arthur Nienhuis, MD, will summarize the abstracts related to gene therapy and comment on their relevance to an emerging and timely research data. Dr. Bauer spoke with ASH Clinical News about this year’s topic:
“Gene therapy has made tremendous advances in recent years and holds great potential for the future of hematology. In this session, we will discuss a number of salient topics highlighted by abstracts being presented at the meeting.
We will also review the results from several ongoing clinical studies, including that of autologous lentiviral gene therapies for hematopoietic stem cell disorders and autologous T-cell therapies for hematologic malignancies. In addition, preclinical work with gene editing holds great promise for a wide variety of malignant and non-malignant hematologic disorders.
With increased knowledge of safe and effective mechanisms to add, modify, and repair genes, opportunities to address the fundamental pathophysiologic underpinnings of hematologic disorders have never been more realistic. These technological advancements, however, must be accompanied by improved basic understanding of disease biology. We are beginning to not only use gene therapies to treat disease, but, by carefully analyzing results of gene therapy trials, we are also gaining novel and unexpected insights into the dynamics of hematopoiesis and immunobiology.”
ASH Practice Partnership Lunch: New Payment Models for Hematology
Sunday, December 6, 2015, 11:15 a.m. – 12:30 p.m.
New models of payment that shift risk from insurers to providers are currently being developed. While many of these models were initially developed for primary-care or common surgical procedures, they are now being developed and used for patients with hematologic diseases. This program addresses some of the challenges posed by attempting to create payment models for hematologic conditions, reviews studies of the utilization of hematologic services, and evaluates how these models are being implemented by insurers. Steven L. Allen, MD, chair of the ASH Committee on Practice and incoming councillor, gave ASH Clinical News an overview of the session:
“We are very excited about this program. We constantly hear about new payment models, but really do not know what they will mean to practicing physicians. Physicians need to be aware of how insurers pay for their services, even if their income is entirely based on salary. Our first speaker will address bundled payments, using hematopoietic stem cell transplantation as the model, followed by a review of resource management, since controlling costs is crucial in all payment models. Finally, we will hear from an insurer who will discuss what is happening in this new environment and how insurers plan to handle the transfer of risk from the insurer to the provider. I strongly encourage all practitioners to attend this lunch session – they will have a lot to digest!”
The Epic Story of Blood
Sunday, December 6, 2015, 4:30 – 5:45 p.m.
The science of blood in health and medicine brings together more than 20,000 hematologists from around the world to the ASH annual meeting, but blood also has long and rich symbolic tradition, having influenced religious expression, literature, art, and thought throughout human history. Noted journalist Lawrence Hill, winner of the CBC’s 2013 Massey Lecture and author of Blood: The Stuff of Life, will present a keynote address exploring the physical and metaphoric meaning of blood. Bob Löwenberg, MD, PhD, editor-in-chief of Blood, is the chair of this featured session and gave ASH Clinical News a preview of his introduction:
“The Blood Journal behaves like the blood in our body: It goes anywhere it is needed, fulfilling multiple highly diverse and essential roles. For 70 years, the Journal has offered a mirror of this diversity and reflects the advances in our knowledge covering a great variation of biologic and clinical domains. Blood has a global position, reaching scientists and clinicians in virtually every corner of our planet. In my introduction, I plan to briefly highlight the development and growth of Blood as a major scientific journal in the field of medicine and biology. The Journal has been a messenger of all of the significant developments in our field; many hematologic journals have come and gone over time, while Blood has remained a stable and faithful partner for successive generations of hematologists. Numerous breakthroughs in our understanding of the biology and advances related to the clinical care in hematology have been reported through the pages of Blood. Who can imagine a world without Blood?”