What did you do for your 50th birthday (or if, like me, you haven’t quite reached it yet — what would you like to do?) Did you splurge on a sports car, or take an exotic vacation? Will you compete in a marathon or triathlon, or perhaps celebrate the event more quietly? Chances are that at least some time was, or will be, spent reflecting on your life thus far, and realigning or refocusing for the journey ahead. Such important milestones often prompt individuals or organizations to take stock of their past, and to carefully plan for their future.

The American Society of Hematology (ASH) is no different. ASH capped off its yearlong celebration of the 50th anniversary of the Society with the 50th ASH Annual Meeting in San Francisco from December 6 - 9. From humble beginnings on the porch of a seaside hotel in Atlantic City, to the colossal 24,000-attendee convention center gathering last month, the ASH meeting has grown over the past half-century to become the essential international meeting focused on hematology research and practice.

This past year’s meeting set a high-water mark in terms of the number of attendees, total number of submitted abstracts (6,362), and breadth of educational offerings. But even more important than the annual meeting’s size, scale, or venue (how can one not enjoy San Francisco?) is the important role it plays in advancing the field of hematology and furthering the goals of the Society. Fundamentally, this year’s 50th anniversary meeting accomplished four important tasks: 1) It provided a venue for the highest-quality educational offerings — an up-to-the-minute summary of the current state of diagnosis and management of hematologic disease; 2) it was a time for intense discussion and scrutiny of new scientific observations; 3) there were plenty of opportunities to discuss and critique therapeutic trials, including the first presentations of numerous novel therapies; 4) physicians and scientists representing broad and diverse disciplines relevant to hematology met for discourse, planned collaborations, and celebrated the past, present, and future of our field.

Staying up-to-date in any field of medicine is increasingly challenging, and this is particularly true in our own specialty area. Rapid application of scientific observations to the diagnosis or management of hematologic diseases means that there can be significant changes in the state of the art, even over the course of a single calendar year. This year’s program spanned the diversity of hematology, with 72 different time slots (38 for education topics and 34 for scientific committee sessions), each of a quality and scope to rival any independent continuing medical education program. More intimate discussion opportunities were offered through 40 different limited-access Meet-the Expert Sessions, or one of six special sessions in which participants had a chance to interact with the “Pioneers in Hematology.” Robert Kyle, MD, known as the “father of myeloma” to many, received the Wallace H. Coulter Award for his lifetime contributions to the study of multiple myeloma. A highlight of the meeting was the outstanding Ham-Wasserman Lecture, presented by Dr. Bob Löwenberg of Rotterdam, who focused on the use of cytogenetics, gene expression markers, and molecular genetic results for better prognostication and tailored therapy in acute myeloid leukemia.

The Plenary Session is the scientific centerpiece of every ASH meeting. The abstracts selected are felt by meeting organizers to be most likely to have a broad impact on either the understanding or therapy of a hematologic disease. Three of the six plenary abstracts focused on the sequence of genetic events after acquisition of ETV6-RUNX1 in childhood precursor B-cell ALL (Dr. Caroline Bateman), how the sympathetic nervous system helps create the hematopoietic stem cell niche from mesenchymal stem cells (Dr. Simon Mendez-Ferrer), and the description of a novel neutropenia-dysmorphology clinical syndrome caused by deficiency of G6PC3 (Dr. Kaan Boztug). Key additional observations in the Late-Breaking Abstracts Session (held on Tuesday) ranged from the recognition of Ten Eleven Translocation 2 (TET2), a novel tumor suppressor gene with rearrangements that precede the JAK2-V617F mutation in myeloproliferative disorders (Dr. Francois Delhommeau), to the role that human adenylate kinase 2 deficiency plays in maturation arrest in myeloid and lymphoid maturation (Dr. Marina Cavazzana-Calvo). With a monumental series of simultaneous sessions brimming with more than 800 oral presentations, the ideas presented and discussions that ensued will fuel the engine of experimental hematology well for 2009.

Although we all read a myriad of journal articles and rely upon the data in the (now weekly) editions of Blood, nothing matches the ASH meeting for the spirited discussion and vetting of clinical trial outcomes. The Plenary Session included several high-profile trial results, describing improved outcomes with the addition of rituximab to dexamethasone for treatment of immune thrombocytopenia purpura (Dr. Francesco Zaja), responses induced by a new oral inhibitor of the tyrosine kinase Syk (fostamatinib disodium) in patients with lymphoid neoplasms (Dr. Jonathan Friedberg), and results of a multicenter trial (PROTECHT) of nadroparin for prophylaxis of cancer patients against thromboembolic events (Dr. Giancarlo Agnelli). Many questions echoed through the large halls of the Moscone Center: How effective are the JAK2 inhibitors for the myeloproliferative disorders? What is current status of the oral thrombopoietin agonists? Which patients with chronic lymphocytic leukemia need to be treated, and what’s the best way to do it? For every question the meeting sessions answered, two more arose in their place. Nothing beats the animated discussion in the lecture or poster hall after a trial is presented to highlight the trial’s strengths and weaknesses, applicability, and most likely follow-up steps.

For the hematologist, the ASH meeting marks the transition to a new year. The annual meeting is a time to present the fruits of one’s past year’s efforts and plan for next year’s experiments or clinical trials. In addition to the official events, the meeting is a time to meet with friends and colleagues from around the world and to gather for early morning investigator breakfasts or late night drug-development-pipeline dinners. This year’s meeting added a special wrinkle: an anniversary reflection on where we have been as a field and where we are going. Capping the wonderful yearlong 50th Anniversary Review series in Blood, the meeting was filled with historical vignettes, ranging from the development of the Society’s logo to the Nobel Prize of E. Donnall Thomas for bone marrow transplantation. The halls echoed with interviews of ASH presidents from years past, to placards of the myriad of major accomplishments that the field can boast. I am sure I speak for many of my colleagues when I say I was filled with tremendous pride over the accomplishments of our field both for science and for patients, I was impressed by the vigor and strength of our Society, and I look with optimism toward our next 50 years.

Finally, I would like to express my gratitude to the dedicated ASH News Daily authors, Drs. Rafat Abonour, James Foran, Michael McDevitt, Bart Scott, and David Steensma.