The 61st ASH Annual Meeting: Unwrapping the Best From Hematology's Christmas

Late December is a favorite time of the year for me. For starters, my Outlook calendar — the digital deity of our age — commands me to attend just five meetings a week, as opposed to 20-plus. Actual tasks can be completed during the workday. I can reply to and file emails, rather than hit “reply all” and hope for the best. Most importantly, this is the time of year when I can reminisce and bask in a post–ASH annual meeting glow.

As I write this, it has been two weeks since the meeting. Chances are that by this time, everyone has had an encounter with what might be the season of mistletoe, casseroles, yuletide treats, and singalong carols. And now we enter this weird interregnum. The new year is still to come, but hematologists’ “Christmas” is over.

Or is it?

Although the annual meeting and many of the festive moments are mixed and blurred with end-of-year deadlines, reports, and paper-writing that stretches the frail credulity of worthy reviewers (many stimulated by the meeting itself), one thought sticks out: No scholarly blind spot or theoretical shortcoming was left unturned this year in Orlando. For me, and for everyone else that I either spoke to or ran into at the annual meeting, the program was simply phenomenal this year. Granted, mine is a circle of mostly coagulationists (without an identity crisis though), and you might have seen them walking around with a certain swag this year (thank you, Dr. Silverstein). Nevertheless, the environment was electric, the energy palpable, and the coffee lines long, even on Tuesday as I walked to the Late-Breaking Abstracts session. Even weeks later, memories from the meeting provide a stimulating distraction from both work and the importunities of the season.

As I look back, this year’s program fulfilled the needs of every hematologist. More than 29,000 attendees walked the Orange County Convention Center. The program boasted 16 Scientific Program sessions, 28 Education Program sessions, and more than 30 Special-Interest and Spotlight sessions on timely topics presented by the world’s leading experts; 930 oral and 3,853 poster abstracts covered the latest research in all areas of hematology, while nearly 300 interactive exhibits gave an in-depth look at the latest industry trends. ASH members are located in major academic medical centers and small community hospitals, some with access to every new health care advance, and others with difficulties in providing services that we all consider quite basic. I would be remiss not to say that this year’s elaborate program catered to all.

Throughout the meeting, I was reminded of the beautiful quote from Sir William Osler: “It is much more important to know what sort of a patient has a disease than what sort of disease a patient has.” I think this year’s sessions lived up to Osler’s teachings. The scientific workshops, satellite symposia, and ASH-a-Palooza set the rhythm for the meeting on Friday, providing something for everyone, even before the official start of the meeting. A host of topics — leukemia and lymphoma, myeloma, amyloidosis, hemophilia, sickle cell disease (SCD), and many more — were covered during the Friday Satellite Symposia. I heard trainees on escalators and walkways singing the praises of the 2019 ASH-a-Palooza. Sessions on health services research topics such as routine immunizations after nonmalignant disorders covered care for these complex diagnoses that go beyond acute management, and into the primary care arena. The ASH Clinical Practice Guidelines Sessions that were peppered throughout the meeting highlighted specific guidelines for a multitude of disorders, including venous thromboembolism, SCD, immune thrombocytopenia, and acute myeloid leukemia. The speakers highlighted notable recommendations of interest that they hoped attendees would learn, disseminate, and implement. If that wasn’t enough, the ASH EQUIPS special symposium on safety discussed medical errors and patient safety. In combination with the ASH Choosing Wisely^® Campaign sessions, both adult and pediatric-focused, these presentations reflected the intersecting concepts of therapeutic effectiveness, clinical value, and financial toxicity.

The Best of ASH session, co-presented by the scientific co-chairs, recapped the amazing science on display at this year’s meeting. Dr. Charles Mullighan highlighted work that described mechanisms of tumor formation; new therapeutic advances in acute lymphocytic leukemia (ALL), myeloma, and myelodysplastic syndromes; and mechanisms of resistance to therapy in chronic lymphocytic leukemia, ALL, and chronic myeloid leukemia. He described single-cell and spatial profiling technology of the tumor microenvironment and advances in immunotherapy. Dr. Robert Flaumenhaft recapped mechanosensing mechanisms and refining cell lineage in nonmalignant hematologic diseases. These sets of studies ran the gamut from how mechanical forces direct the development of hematopoietic stem cells, to the efficacy of oral arginine in the treatment of vaso-occlusive crises in children.

Last, but certainly not least, the award ceremonies at ASH commemorated giants in the field and acknowledged leaders who embodied the attributes of the award’s namesake. Dr. Richard Aster received the 2019 Wallace H. Coulter Award; Drs. Sriram Krishnaswamy and Jeffrey Weitz, the Earnest Beutler Lecture and Prize; Dr. Philip Greenberg, the E. Donnall Thomas Lecture and Prize; and Dr. Emmanuelle Passegué, the William Dameshek Prize. Drs. William Eaton and Richard Larson received the Henry M. Stratton Medal, and the ASH Mentor Award celebrated the time and effort of two outstanding mentors, Drs. Michael R. DeBaun and Leonard Zon.

Spanning disciplines, disease sites, and treatment approaches, it is our combined knowledge that will shape the future of patient care and research. With exciting advances in big data technology, our collective wisdom will become all the more powerful, as new insights will reveal in seconds, not years. The impact of our knowledge, however, can only be as significant as our ability to strengthen the delivery of high-quality hematologic care. I hope that 50 years from now, future hematologists will look back and thank us for the pioneering aspects of hematology treatments that developed in our era.

It was wonderful to see so many of you at the 2019 ASH Annual Meeting, connecting with colleagues, augmenting our collective knowledge, and strengthening our ability to provide high-quality care to our patients. Before I sign off and welcome the next decade, I would like to thank my ASH News Daily Editorial Board, which worked tirelessly to cover the entire meeting.