DAY 3
October 2nd 2021
Myeloid
Updates in Myelodysplastic Syndromes
Dr. Mikkael Sekeres, Sylvester Comprehensive Cancer Centre
Presentation Summary
MDS is a Cancer
- For Lower-risk MDS, focus on what bugs patient most:
- Anemia
- Thrombocytopenia
- Same for Higher-risk, and focus on Response Duration, Overall Survival.
- Considerations for Modifying Multilineage Dysplasia
- Specific HMAs Options and Higher-risk MDS Combinations
Novel Approaches Including Non-Intensive Induction in AML
Dr. Guillaume Richard-Carpentier, Queen’s University
Presentation Summary
Integrated genetic profiling is now critical to inform treatment decisions for patients with acute myeloid leukemia
Multiple novel therapeutic options are available for patients with newly diagnosed AML who are ineligible for intensive chemotherapy
These options offer but require:
- Improved efficacy
- Different response kinetics and monitoring required
- Specific side effect profiles to monitor
There is hope for further improvements in the treatment and clinical outcomes of older patients with AML
Future Perspectives
- Targeted agents available for patients with relapsed / refractory AML
- Utilization of lesser intensity regimens in younger patients with AML or older patients who are eligible for intensive chemotherapy
- Evaluation of triplet-drug regimens in older patients with AML
- Integration of FLT3 inhibitors
- Integration of IDH1/2 inhibitors
- Identification of subsets of patients for treatment-free remission?
- Very-high risk AML remain an urgent unmet need (t-AML, TP53 mut, CK)
- Anti-CD47 antibodies (e.g. magrolimab)
- Checkpoint inhibitors (e.g. anti-TIM3 antibodies)
Clinical Updates in Myeloproliferative Neoplasms
Dr. Mrinal Patnaik, Mayo Clinic
Presentation Summary
Myeloproliferative neoplasms are hematological stem cell malignancies enriched in driver mutations signaling through the JAK-STAT pathway (JAK2, CALR and MPL) and are associated with morbidity and mortality.
Classical MPN consist of Essential Thrombocythemia (ET), Polycythemia Vera (PV), and Primary Myelofibrosis (PMF)
ET and PV associated with thrombotic morbidity
JAK STAT signaling is enhanced in MPN with driver mutations including JAK2, CALR and MPL
- Triple negative MPN- aggressive and poor outcomes
Treatment algorithms based on risk stratification
Definite role for allogeneic HCT
Emerging options – Epigenetic-based Therapies in Myelofibrosis Therapy
Challenges in Hematology
Challenges of Older Patients
Dr. Stefano Luminari, University of Modena and Reggio Emilia
Presentation Summary
- Older/frail patients are hard to treat and require a multidimensional and personalized approach
- Expert and dedicated teams are needed
- Management of older patients cannot be limited to a discussion about one standard therapy…“Perfect can be enemy of the good”
- Frailty is not comorbidity and is not absolute.
Intersectionality in Haematology
Dr. Nada Hamad, St. Vincent’s Hospital Sydney
Presentation Summary
Intersectionality in Health
- A framework that focuses on the ways multiple axes of inequality intersect and compound at macro and micro levels to produce a broad range of unequal health outcomes. It is time to integrate intersectionality in all aspects of medicine so that we can deliver effective and compassionate care for all.
Covid 19 vaccination in CLL and Heme Malignancies
Dr. Gwen Nichols, Leukemia & Lymphoma Society (LLS)
Presentation Summary
Leukemia and Lymphoma Society in US created a patient registry to understand safety and efficacy of vaccination in the blood cancer population
- Patients with hematologic malignancies have worse outcomes if infected with COVID-19 compared to the normal age-matched population (Vijenthera et al., 2020)
- Cancer patients were largely excluded from the vaccine trials
(Griffiths and Segal, 2021)
- Suggestion that ALL blood cancer patients: “GET VACCINATED, ACT UNVACCINATED”
