An Unabashed Rehash of the ASH Dash

Director of the Leukemia Program at the Cleveland Clinic in Cleveland, Ohio, and editor-in-chief of ASH Clinical News

(Or, How to Write an Abstract Guaranteed to be Selected for a Plenary Presentation at the Annual Meeting*)

6:15 a.m. (EST), August 4, 2015: My alarm clock goes off. This is the day: the abstract deadline for the ASH annual meeting. I get out of bed and stand in front of my bedroom mirror to perform my daily positive affirmation exercises (the ones I learned from Stuart Smalley, the self-help addict portrayed by Al Franken on “Saturday Night Live”). I look at my reflection, and I repeat the following mantra:

Today, I will write an abstract that will be accepted by ASH to be a plenary presentation at this year’s annual meeting.

Because I’m good enough to write this abstract.

I’m smart enough to write this abstract.

And, doggone it, people like me!

7:00 a.m.: I drive to work. Lots of construction; it’s orange-barrel season. When I arrive, I will open my email inbox to find the message that my statistician has been promising me – the one with results that will change the way we treat acute leukemia.

My hypothesis is so maddeningly simple, I can’t believe nobody has thought of it previously. It all has to do with the chloride. A patient’s baseline chloride should be able to predict that patient’s response to induction chemotherapy and overall survival! The mechanistic biology is painfully obvious: chloride channels in blasts. It’ll be a call to arms for recommending more aggressive therapy in certain patient subsets. How could it not be accepted as a plenary presentation?

I start practicing my introductory comments for when I walk on stage for the plenary session at the annual meeting, in my head: “I’d like to thank the president of ASH, Dr. Williams, and the incoming president, Dr. Abrams, and the selection committee …”

7:20 a.m.: I open my email inbox. Nothing from the statistician. Really? I sent him my Excel spreadsheets of all the data I abstracted from patient charts two days ago, along with my request to also analyze 78 other baseline variables. What’s taking him so long?

I start writing the introduction to the abstract.

7:21 a.m.: I check my inbox again. No email.

7:22 a.m.: I check my inbox again. Still no email.

7:23 a.m.: I check my inbox again. Really? Still? I sure hope he’s enjoying his breakfast this morning while I’m trying to cure cancer.

7:24 a.m.: I write the statistician an email asking for my data. I promise myself not to check my email again for another hour while I bang out this intro.

7:25 a.m.: I check my inbox again. Nothing.

10:14 a.m.: I have finished my intro. I decided to give a brief history of leukemia, starting with Virchow, to put my discovery into context. I’m at 5,300 characters without spaces. I’d better check the abstract guidelines on the ASH website to make sure I’m not running over.

10:15 a.m.: What?! 3,800 characters without spaces? Why don’t they just ask us to Tweet out our abstracts, while they’re at it? I start cutting the portions of my intro from the 18th century. Most of the good stuff happened in the 19th and 20th centuries, anyway.

10:30 a.m.: Time for another positive affirmation session in front of my work mirror. I am good enough to write this abstract.

11:23 a.m.: The statistician finally emails back. He has to do a lot of “data cleaning,” whatever that means. He’ll have my results to me within 6 hours. I start writing the results section of the abstract. I might as well – I know which way this thing is going.

1:45 p.m.: The results section is basically finished, except for the Kaplan–Meier survival curves I’ll ask for. Because a picture is worth 1,000 characters without spaces.

2:00 p.m.: Lunch. Since my hospital just kicked out McDonald’s, I guess I’ll go for a salad instead. Or maybe I’ll just eat this leftover KFC I brought from home …

3:11 p.m.: I finish lunch. I’ll just work on the conclusion, should only take about 10 or 12 sentences.

4:05 p.m.: Positive affirmation session. I am smart enough to be on stage with Dr. Williams.

5:30 p.m.: Email from the statistician, with attachment! Here’s the moment we’ve all been waiting for. I open it and … Wait – what?

Here are the tables, baseline characteristics, univariate analyses, and a p Value of 0.83 for the association of chloride with response to chemotherapy. That can’t be!

Well, maybe it just stabilizes disease and people live longer. I move on to his survival analyses and find … a p Value of 0.97? Huh? This doesn’t make any sense! My logic behind this was airtight. How could he not find an association within the data I sent him on 23 patients? There has to be something here we can present at the annual meeting. Let me scan the other variables.

5:35 p.m.: Bicarbonate! Of course – bicarbonate channels in blasts! It makes so much sense. And with a p Value of 0.063 for response to chemotherapy, this will be at least an oral presentation. I email the statistician; he’ll have to re-run his analyses now focusing on bicarbonate!

6:03 p.m.: The statistician emails back. He is working on data for other abstracts, he’ll get the new analyses back to me in a few hours. That’s okay, I’ve got to re-write this bad boy.

8:37 p.m.: Still working on the abstract, take a break for a positive affirmation session. I am the King of Bicarbonate.

11:06 p.m.: Email from the statistician with new analyses. No association of bicarbonate with survival, and all associations disappear in multivariate analyses. But at this point, I think I’m good to go anyway. This is the first time anyone has ever shown the importance of baseline bicarbonate in acute leukemia. I’ll leave it for other investigators to gather the sample size to prove what’s obvious anyway – bicarbonate runs the show.

11:53 p.m.: I’ve entered all the new data and proofread my abstract. I upload it to the ASH website and … what? “Too many characters without spaces?” 4,900 characters? How can that be? It must be the tables! I’ll never get it down to 3,800 characters in time! All this work for nothing, not to mention depriving the world of this finding!

I bang my head on my desktop over and over again. But wait, let me check the ASH website. … Yes! Pacific Time! The deadline is 11:59 p.m. Pacific Time! I’m saved! Thank you ASH, which is based in Washington, DC, for making the abstract submission deadline Pacific Time!

2:04 a.m. (EST), August 5, 2015: Email from [email protected]: “This message serves as confirmation that your submission was received.”

*Guarantee of acceptance to the ASH Annual Meeting is only within the warped and often delusional mind of the author.

The content of the Editor’s Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated.

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