Calendar
IN-PERSON AND VIRTUAL
ASH Meeting on Hematologic Malignancies
September 10-11 , 2021 Chicago , Illinois
Top experts in hematologic malignancies discuss the latest developments in clinical care and provide answers to challenging patient care questions in a small-group setting . The program content is structured as “ How I Treat ” presentations , which showcase each speaker ’ s evidence-based treatment approaches .
VIRTUAL
National Hemophilia Foundation ’ s State of the Science Research Summit
September 12-15 , 2021 The summit will bring together multidisciplinary experts from a wide range of fields that shape bleeding disorders research , clinical care and patient support , as well as patients , caregivers and allied community members , for discussions on six critical themes for research .
VIRTUAL
2021 International Workshop on Chronic Lymphocytic Leukemia
September 17-20 , 2021 This biennial international conference will focus on the progress in biology , genetic characteristics , diagnostic approaches , and development of new therapies for chronic lymphocytic leukemia and related lymphoproliferative disorders .
VIRTUAL
JADPRO Live 2021
October 7-17 , 2021 JADPRO Live , the annual meeting of the Advanced Practitioner Society for Hematology and Oncology ( APSHO ), is designed for and by advanced practitioners , including nurse practitioners , physician assistants , clinical nurse specialists , pharmacists , and advanced degree nurses .
IN-PERSON
2021 ASTRO Annual Meeting
October 24-27 , 2021 Chicago , Illinois
With a theme of “ Embracing Change , Advancing Person-Centered Care ,” this year ’ s annual meeting of the American Society for Radiation Oncology highlights the importance of embracing the rapid advancements in the field of radiation oncology to provide the best patient care in the most efficient way .
IN-PERSON AND VIRTUAL
2021 American Society of Hematology Annual Meeting
December 11-14 , 2021 Atlanta , Georgia
The 63rd ASH Annual Meeting and Exposition will provide an invaluable educational experience and the opportunity to review thousands of scientific abstracts highlighting updates in the hottest topics in hematology .
You Make the Call : Readers ’ Response
We asked , and you answered ! Here are a few responses from this month ’ s “ You Make the Call .”
For the full description of the clinical dilemma , and to see how the expert responded , turn to page 18 .
CLINICAL DILEMMA :
This case is regarding a patient with T-cell large granular lymphocytic leukemia ( T-LGL ). A 73-year-old-asymptomatic female was found to have severe neutropenia ( absolute neutrophil count < 0.3 × 10⁹ / L ). On exam she did not have splenomegaly . A bone marrow biopsy showed diffuse extensive replacement of the marrow architecture with T-LGL . T-cell receptor gene rearrangement analyses were identified both beta- and gamma-positive clones . A metaphase karyotype done on the bone marrow aspirate was normal , and fluorescence in-situ hybridization testing for del6q was negative . Molecular testing identified a point mutation in STAT3 ( Y640F ).
Her T-LGL responded briefly ( 1 week ) to prednisone . She was then treated with methotrexate ( 20 mg / week for 3 months ) without improvement in her disease . Likewise , her disease did not respond to oral cyclophosphamide . She has now started cyclosporin . How would you recommend this patient be managed ? Is there a role for tofacitinib ? Are there any novel or clinical trial options ?
HELP HEMATOLOGY PATIENTS FIND YOU !
If the assay is available , studying erythroid blast forming units ( BFU-E ) in the presence / absence of patient T cells can be very useful to ensure that the hypoproliferative anemia is due to the T-cell subset . If this remains the case , a trial of cyclosporine is OK , but if the patient is robust , one could consider rabbit antithymocyte globulin and cyclosporine .
If the T-cell depletion does not lead to robust BFU-E , next-generation sequencing should be performed to look for evidence of a myelodysplastic syndromes ( MDS )– related clonal abnormality ( this should have already been done ). If they one is present , then an MDS-oriented therapeutic strategy may be warranted .
Steven Gore , MD Rockville , MD
As the patient is asymptomatic , I would not treat until she has had at least one admission with febrile neutropenia . I have not had success with methotrexate in this setting . If she requires intervention , I would give her two to four cycles of bendamustine plus rituximab , as tolerated and depending on response .
ASH members can help patients find their hematology practice by signing up to be included in ASH ’ s Find a Hematologist directory .
Visit www . hematology . org / education / patients / find-a-hematologist to add your information !
There is a special need for doctors who care for patients with sickle cell disease , so please visit the Find a Hematologist directory to sign up !
Leanne Berkahn , MD Auckland , New Zealand
4 ASH Clinical News August 2021