I am writing this in the waning days of December 2019, the end of the year and the closing of a decade. It’s a good opportunity to look back at where we’ve been and to look forward to see if any course adjustments are necessary.
The frenzy of the 2019 ASH Annual Meeting has passed. Dr. Roy Silverstein presided over a very successful meeting and year, and I wish to extend my personal thanks and congratulations to him. A record number of people gathered in Orlando, exchanged knowledge and new ideas, and carried that energy home with them to nearly 100 countries. ASH’s reach through our many meetings, publications, training initiatives, and international projects is indeed global.
The past decade has brought remarkable progress in our field with first-in-class advances. Dabigatran was approved in 2010. Ruxolitinib was approved in 2011. With the signing of the Affordable Care Act in 2010, millions in the U.S. gained access to health insurance. Lifetime caps and pre-existing conditions went away, although the financial devastation of illness persists. The first checkpoint inhibitor, ipilimumab, was approved in 2011, and the first CAR-T and bispecific antibody therapies were approved in 2017. The first small-interfering RNA treatment was approved in 2018.
As an allogeneic hematopoietic cell transplant physician, I now struggle with whether to recommend transplantation to people who have reached deep molecular remissions by ingesting small molecular inhibitors or receiving antibody-based therapies or CAR-T cells. I meet with people who have sickle cell disease to talk about transplantation, and we discuss the pros and cons of transplantation now versus waiting for when gene therapy might be available. The fact that I’m talking to them about transplant at all, and that gene therapy is mentioned in the same conversation as a potential alternative, albeit on a clinical trial, is remarkable.
This issue of The Hematologist is filled with articles about advances in the past year, and ASH’s goal for more than 60 years has been to support hematologists in their work. To continue this important mission, ASH has supported laboratory and clinical investigators by providing more than $12 million in the past year in grants, scholarships, and career development programs. We’ll use our publications and meetings to disseminate reliable information and package it in ways that busy people prefer. We’ll make sure the public and legislators know why research funding is so important to keep the breakthroughs coming, and we’ll advocate for other policies that benefit our patients and our field. ASH has other initiatives in sickle cell disease, data registries, recruitment and retention, mentoring, and clinical practice guidelines that you’ll continue to hear about. And we’ll work worldwide to improve hematologic care.
Yet, for the patients we care for, leukemias are still resistant, graft-versus-host disease still fails to respond to treatment, and people still suffer and die from hematologic illnesses. So the challenge for the next decade is to maintain momentum so that we can look back in 10 years at 2020 and again marvel at how far we’ve come. I know that ASH and our field are on a good course to achieve this goal. Happy New Year!
