Click here to view as PDF.49th Annual Meeting of the American Society of Hematology
Focus of hematological malignancies and notable research
The American Society of Hematology (ASH) held its 49th Annual Meeting at the Georgia World Congress Center in Atlanta in December. The Society's annual meeting provides a forum for hematologists from around the world to discuss critical issues in hematology.
Roughly 20,600 clinicians, scientists, and other hematology professionals hailing from over 100 countries attended the four-day meeting, which consists of educational programs and scientific sessions that address a wide range of issues relating to and covering the entire spectrum of hematological disorders.
In addition, the annual meeting features oral and poster presentations, chosen by peer-reviewers from abstracts submitted prior to the meeting, that feature the latest breaking developments in scientific research. For the 2007 meeting, 3,745 abstracts from 46 countries were accepted for presentation.
Mitchell Weiss, MD, PhD, Children’s Hospital of Philadelphia, Pennsylvania, and Scientific Co-Chair of ASH 2007, summarized its value in the following terms: “If you’re a practicing hematologist/oncologist, ASH is a very important meeting covering diverse topics. The educational and scientific sessions provide overviews of what’s hot in the field. So it’s a good place for clinicians to brush up the latest, newest emerging concepts that they might not see all the time. One can find out what the state of the art research is that will be coming into clinical practice five years from now. ASH offers a very comprehensive global view, from practical, clinical issues to cutting-edge research. Everything is important (in terms of) current clinical practice, clinical practice alterations, and things that are going to become clinical practice.”
The following highlights provide summary coverage of meeting highlights, primarily focusing upon notable research breakthroughs relating to hematological malignancies.
â–º Advances in Multiple Myeloma
Second in prevalence only to non-Hodgkin’s lymphoma, multiple myeloma (MM) is one of the most common hematologic malignancies in the United States. This severe form of bone marrow cancer is also one of the most
difficult to treat. Traditionally, MM outcomes have been poor. Survival rates for MM have not been promising: most patients die within two to three years after diagnosis. In 2007, an estimated 10,790 fatalities were attributed to the disease in the United States. However, over the past decade, survival rates have risen dramatically. Recent analyses delivered by numerous presenters at the 49th Annual American Society of Hematology meeting suggest that this trend may be attributed to new types of drugs, new treatment combinations and aggressive therapeutic interventions such as stem–cell transplantation (SCT).Bortezomib-Melphalan-Prednisone Associated with Improved Efficacy Endpoints Compared With Melphalan-Prednisone in Newly Diagnosed Multiple Myeloma
Jesus San-Miguel, MD, Hematology Department Head, University Hospital of Salamanca, Salamanca, Spain, presented results from a 682-patient, randomized, Phase III trial comparing bortezomib (Velcade)-melphalan (Alkeran)-prednisone (Meticorten) (BMP) versus melphalan-prednisone (MP) in the treatment of patients with newly diagnosed MM who were ineligible to receive SCT.
Patients in the BMP arm of the study received bortezomib at 1.3 mg/m2
twice weekly in weeks one, two, four and five for four six-week cycles (eight doses per cycle), followed by once weekly on weeks one, two, four and five for five six- week cycles (four doses per cycle) in combination with melphalan at 9 mg/m2
and prednisone at 60 mg/m2
once daily on days 1 through 4 of each cycle. Patients in the MP arm received nine six-week cycles of MP once daily on days 1 through 4. For both groups, treatment continued for a maximum of 54 weeks (52 vials) with a median number of 46 weeks (44 vials) reported in the trial. The safety profile of BMP was as expected, based on the known safety profile of each of the three individual agents in the combination. Adverse events included neutropenia, thrombocytopenia, anemia and peripheral neuropathy. Discontinuation because of adverse events was low and similar in both arms.
Responses were evaluated by the commonly used M-protein levels measured in serum or urine by a centralized laboratory as well as the most stringent European Group for Blood and Marrow Transplantation (EBMT) criteria. Key findings reported by Dr. San-Miguel included: an immunofixation-negative complete remission (CR) rate of 35% in the BMP arm compared with 5% with MP (P
< 0.000001); a CR rate of 30% in the BMP arm compared with 4% with MP; a 24-month median duration of response for patients with CR in the BMP arm compared with 13 months in the MP arm; a 24-month time-to-disease progression (TTP) in the BMP arm, compared with 17 months with MP (P
= 0.0000001); and a statistically significant demonstration of overall survival associated with the BMP arm (a 40% reduction in risk of death (P
= 0.0078) was observed in the patient cohort undergoing BMP therapy).