17th European Haematology Association (EHA) Congress

Dr Mullighan talks to ecancer at the European Hematology Association congress 2012. Whole genome sequence analysis of MLL-rearranged infant ALL has revealed remarkably few mutations in a study from the St Jude Children's Research Hospital and Washington University Pediatric Cancer Genome Project. (MLL = Myeloid/lymphoid or mixed-lineage leukemia gene) A small number of genetic changes are needed to drive this disease, meaning epigenetic approaches may be therapeutically beneficial. BCR-ABL-like leukaemia is also discussed, and better screening for patients at diagnosis. Whole genome sequencing for ALL is still in the early stages, but in the next few years enough should be understood to put new therapies in the clinic.

Giora Sharf, Director of the Israeli CML Patients Support Group, talks to ecancer at the 17th European Haematology Association Congress in Amsterdam about what patients have contributed to the study of chronic myeloid leukaemia. A large issue in the patient community is that of adherence, which the CML Patients Support Group aims to address through a new, large scale survey. In previous studies, the group found that 25 to 30% of patients do not take the drugs given to them, and this can have extremely detrimental effects on a patient’s outcome. If a patient takes less than 90% of dosage, they only have ¼ of chance to achieve complete response. Reasons cited for a lack of adherence range from too many negative side effects to forgetfulness.

Dr Jing Chen talks to ecancer at the 17th European Haematology Association Congress in Amsterdam about tyrosine phosphorylation and cell metabolism in leukaemia. Understanding how cancer changes the cellular metabolism and how leukaemia cells generate ATP energy is still in its early stage, though it is known that tyrosine phosphorylation occurs because of the cancer. The most important work done now is to understand how post-translational modification would change properties at the cellular level and the identification and understanding of critical players in cellular pathways, allowing for use as therapeutic targets. Dr Chen discusses PK-2, which is the most important enzyme as it controls speed of glycolosis, and LDH, which have already been identified as important therapeutic targets.

Prof Porter talks to ecancer at the European Haematology Association meeting in Amsterdam June 2012. Iron overload can cause death when patients have survived other diseases such as cancer. Progress has been made in to understanding the molecular processes behind haemochromatosis and new MRI techniques allow clear imaging. Individuals at the greatest risk of iron overload can now be identified and given personalised treatment accordingly. Dr Porter looks at upcoming tools for assessing iron overload and covers iron level issues in myelodysplastic syndrome (MDS).

ecancer talks to Dr Mark Frattini, at the 17th European Haematology Association Congress in Amsterdam, about a method of testing patients with acute myeloid leukaemia in order to identify drug sensitivity and resistance. The test looks at patient’s cells by placing them in a type of acid for four days, and then checking them with up to 60 agents to identify their response; agents used include novel agents and FDA approved agents. The results from this test build a personal treatment for each patient. The study was conducted in a retrospective fashion with 25 patients to show sensitivity and resistance to prior treatments. This did allow for new treatments to be identified for five patients in the study, generating enough response to allow for bone marrow transplants. Dr Frattini now hopes to put this test into a prospective setting with a phase 1 clinical trial.

Leading patient advocate Jan Gessler talks to ecancer at the 17th European Haematology Association Congress in Amsterdam about patient advocacy in haematologic malignancy treatment. Quality of life treatment for patients does not just include day-to-day caring, but the effects on the patient community as a whole. A session at EHA 17 showed doctor's and patient's common miscommunications which occur when doctors misinterpret how patients feel either because of due to misunderstandings or lack of information. Recently, guidelines on the quality of life care was published for haematologists, setting criteria and providing an example of how doctors should address and assess these issues.

Prof Keating talks to ecancer at the 2012 European Haematology Association conference in Amsterdam. He covers how to treat chronic lymphocytic leukaemia (CLL), which can be often best left alone. He suggests that the current best treatment is the FCR (Fludarabine, Cyclophosphamide, Rituximab) regimen. Another option is the BR (Bendamustine, Rituximab) regimen which has yet to be fully tested. 17p deletion type CLL unfortunately has a much worse outcomes than other CLL types. Prof Keating also covers alemtuzumab, allogeneic stem cell transplant and new molecule PCI32765 as an oral medication.

Prof Willem Fibbe talks to ecancer at the 17th European Haematology Association Congress in Amsterdam about the use of mesencymal stromal cells and graft-versus-host disease. Mesenchymal stromal cells and stem cells have the ability to modulate and suppress immune responses. These cells are used to suppress a particular disease, graft-versus-host disease, which comes from an allergic response during the transplantation of cells. These cells are harvested from bone marrow and other tissue sources. Normally a specific donor is chosen for each patient. Prof Fibbe also discusses a randomised study that will focus on severe graft-versus-host disease, which also affects the liver, where the patient will be treated with steroids and then two infusions of MSCs, one week apart, if there is no response to steroids.