60th ASH Annual Meeting Wrap-up: A Game Changer in San Diego

To me, the 2018 ASH Annual Meeting felt different. It had a fresh and energetic vibe. The member-centric emphasis of the meeting was evident. From the get-go, the brilliant idea of registration and materials pickup at the airport was a Twitter sensation. It was clear that attendees also appreciated the thoughtful inclusion of Alexa-Ask ASH in Japanese, the Expressions of Clinician Wellbeing art exhibit, ASH Assist, and free collaboration rooms, among other great amenities. The evolution of Trainee Day into the fun-filled ASH-a-Palooza just before the official annual meeting kickoff really set the stage for a memorable meeting.

The quality of data presented at this year’s meeting will inform our practice for years to come. The scientific and education program sessions were carefully planned to meet the needs of a variety of disciplines nested under the vast field of hematology. The Global Capacity-Building Showcase touted the Society’s international collaborations in the form of fostering growth in low- and middle-income countries. The well-attended ASH-FDA (U.S. Food and Drug Administration) Joint Symposium on New Drug Approvals featured drugs with recent approvals to treat blood disorders, coupled with the FDA’s insight into the drug approval process. New this year, ASH President Dr. Alexis Thompson delivered a State-of-the Society address and shared her insights on the many ways in which ASH works on behalf of its members to advance the mission of “helping hematologists conquer blood disease worldwide.”

Sunday’s Plenary Scientific Session lived up to its promise. We learned about luspatercept, a novel drug that was shown to significantly reduce transfusion requirements in adult patients with very low–, low-, or intermediate-risk myelodysplastic syndrome with ringed sideroblasts in the MEDALIST trial. In the landmark REACH trial, hydroxyurea was shown to significantly increase hemoglobin concentrations and reduce veno-occlusive crisis and chest pain syndrome in patients with sickle cell disease (SCD) in African countries. Thanks to this session and the research performed in Krause Lab at Yale University, hematologists now finally know why platelet counts are elevated in patients with iron deficiency anemia. (Bring it on, students/residents and fellows!) Another study with immediate practice implications was the Alliance A041202 randomized trial, which revealed two key messages. First, the addition of rituximab to ibrutinib in patients with chronic lymphocytic leukemia (CLL) does not add to the duration or depth of disease response. Additionally, ibrutinib improved progression-free survival (PFS) compared to bendamustine and rituximab combination therapy, ushering in an era of chemo-free frontline therapies in CLL. To learn more about these and other plenary abstracts please visit the newly launched www.ashnewsdaily.org and look for coverage from the December 3 (Monday) issue.

The Late-Breaking Abstracts (LBAs) session on Tuesday morning ensured that the meeting ended with seven new, game changing studies. The CASSINI trial showed that rivaroxaban prophylaxis significantly reduced venous thromboembolism (VTE) and VTE-related death during the on-treatment period in cancer patients. The MAIA trial heralded the arrival of monoclonal antibodies in the frontline setting in transplant ineligible myeloma patients by showing a PFS benefit with daratumumab, lenalidomide, and dexamethasone (D-Rd) combination (median PFS not reached) versus the standard Rd combination (median PFS 31.9 months). In the third LBA, HemoTypeSC^TM emerged as a possible low-cost, reliable, point-of-care diagnostic test for SCD in developing countries. The results of E1912 showed PFS and overall survival benefit with ibrutinib-based therapy in newly diagnosed younger CLL patients, arguably making FCR (fludarabine, cyclophosphamide, and rituximab) therapy a relic. The safety and efficacy data of emapalumab in pediatric patients with primary hemophagocytic lymphohistiocytosis (HLH), resulted in the FDA granting emapalumab approval, making it the first agent to receive approval for primary HLH.

It was an honor serving as the 2018 Editor of ASH News Daily. I witnessed firsthand the passion, energy, dedication, and hard work the ASH staff put in to make this meeting a resounding success. If you want a recap of the meeting, please check out the ASH News Daily articles online at www.ashnewsdaily.org. The 61st ASH Annual Meeting will take place in Orlando, Florida, next year, and I look forward to seeing you all there!