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American Society of Hematology's 48th Annual Meeting, Dec. 9-12, 2006

The American Society of Hematology 48th Annual Meeting and Exposition

The American Society of Hematology's (ASH) 48th Annual Meeting and Exposition took place Dec. 9-12 in Orlando, and drew more than 21,000 attendees from around the world. The conference presented groundbreaking research resulting from molecular studies, a significant advance in the treatment of severe sepsis, and educational sessions that may affect future clinical practice.

"If there was one theme, it was the use of molecular studies to identify prognostic groups, which in turn is going to determine treatment strategies," said Armand Keating, M.D., of Princess Margaret Hospital in Toronto, Ontario, and secretary of ASH. He cited several studies that are likely to change clinical practice.

"One example was a German study (led by Richard Schlenk, M.D., of the University of Ulm) that looked at gene mutations in adults with acute myeloid leukemia who didn't have a chromosome abnormality," Keating said. "They came up with the very interesting observation that there's a specific subgroup that does very well with allogeneic stem cell transplantation. That's important, because the feeling until now was that patients with normal cytogenetics would be considered in an intermediate-risk category and perhaps not be candidates for a sibling donor transplant."

Another example of practice-changing research was a 13-year collaboration between researchers in the United Kingdom, the United States and South America, Keating said.

"Their conclusion was that there are some standard-risk acute lymphoblastic leukemia patients who may benefit from allogeneic transplantation," Keating said. "Because previous studies lumped all ALL patients together, this was perhaps not considered to be the standard of care. The researchers showed that standard-risk patients may well benefit from an allotransplant rather than proceeding with consolidation and maintenance chemotherapy, which takes up to three years."

Another example of practice-changing research was an Italian study led by Alessandro Vannucchi, M.D., of the University of Florence, which assessed the relationship between the mutant Jak2 allele and severe manifestations of polycythemia vera, Keating said. "That allows for a risk stratification of patients who might benefit from more aggressive therapy. It's part of the whole notion of how molecular studies increasingly affect how we subdivide disease and treat selected patients."

The meeting's highest-ranked abstract, by Hartmut Wieler, Ph.D., of the Blood Center of Wisconsin in Milwaukee and colleagues, was also its most newsworthy, said Elaine Muchmore, M.D., of the University of California San Diego and editor of the meeting's onsite newspaper.

In an animal model, the study showed that a modified version of activated protein C, which has reduced anticoagulant activity, is just as effective against sepsis as the version approved by the FDA in 2001 but may have a lower risk of bleeding. "That was just remarkable," Muchmore said. "It was probably the biggest news at the meeting."

"I would see this as something that would translate pretty quickly into clinical benefit," Keating added. "We all have patients who end up in the ICU with septic shock. Maybe the use of modified activated protein C would be a useful strategy in treating patients with septic shock."

According to Muchmore, two of the meeting's most popular presentations, which attracted about 6,000 attendees each, were educational sessions led by Aaron Ciechanover, M.D., 2004 Nobel Laureate in Chemistry, who spoke on "Ubiquitous Actives of Ubiquitin," (Full Text) and by Richard Stanley, M.D., who spoke on "CSF-1 (colony stimulating factor-1) -- The Swiss Army Cytokine of Innate Immunity." (Full Text)

"Dr. Ciechanover's lecture was a tour de force overview of the ubiquitin-proteolytic system and how it is important to the understanding of the pathogenesis of disease and as a targeted system for new agents," Muchmore said.

The meeting's Presidential Symposium featured several speakers who addressed micro-RNAs, which are naturally occurring double-stranded RNAs that regulate gene expression. "It's an important emerging issue," Keating said. "If they're involved in the regulation of various biological systems, including the immune system, then perhaps they're amenable to manipulation. But that's years down the road." (Full Text).

ASH: Intervention Promising in Graft-Versus-Host Disease

WEDNESDAY, Dec. 13 (HealthDay News) -- In patients undergoing stem cell transplantation, the risk of graft-versus-host disease may be reduced by treatment with bactericidal/permeability-increasing protein, which blocks and neutralizes endotoxin, according to research presented this week at the 48th Annual Meeting of the American Society of Hematology in Orlando.

ASH: Racial Gap in Leukemia, Lymphoma Survival

TUESDAY, Dec. 12 (HealthDay News) -- Survival rates of black and white children and adolescents diagnosed with leukemia and lymphoma have evened out since 1975, but racial disparities have become more pronounced among patients diagnosed between the ages of 20 to 29, according to research presented this week at the 48th Annual Meeting of the American Society of Hematology in Orlando.

ASH: Chelation May Help Myelodysplastic Syndrome

TUESDAY, Dec. 12 (HealthDay News) -- Iron chelation therapy may improve outcomes in patients with myelodysplastic syndrome who are treated with frequent anemia-related blood transfusions that can cause iron overload, according to research presented this week at the 48th Annual Meeting of the American Society of Hematology in Orlando.

ASH: Pregnancy Loss Studied in Gene-Mutation Carriers

TUESDAY, Dec. 12 (HealthDay News) -- Among women who miscarry during a first pregnancy, the chances of a successful subsequent pregnancy are comparable between carriers and non-carriers of factor V Leiden and prothrombin 20210A mutations. The treatment of carriers with anticoagulant drugs such as low-molecular-weight heparin to prevent a second miscarriage should not be initiated until ongoing studies show its efficacy and safety, according to research presented this week at the 48th Annual Meeting of the American Society of Hematology in Orlando.

ASH: Biologic Agents May Improve Lymphoma Outcomes

MONDAY, Dec. 11 (HealthDay News) -- Minimally toxic biologic agents can either add to the effectiveness or reduce the toxicity of standard chemotherapy treatments for certain lymphomas, according to research presented this week at the 48th Annual Meeting of the American Society of Hematology in Orlando.

ASH: New Options for Gleevec-Resistant Leukemia

MONDAY, Dec. 11 (HealthDay News) -- Two novel compounds can effectively treat chronic myelogenous leukemia and acute lymphoblastic leukemia patients who are imatinib-resistant, according to research presented this week at the 48th Annual Meeting of the American Society of Hematology in Orlando.

ASH: Mechanism of Activated Protein C Investigated

MONDAY, Dec. 11 (HealthDay News) -- The anticoagulant action of activated protein C, or APC, -- the only FDA-approved treatment for severe sepsis -- is not the key reason the treatment is effective, according to research presented this week at the 48th Annual Meeting of the American Society of Hematology in Orlando.

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