EBMT NEWSLETTER | November 2016 | Volume 54 - Issue 5

EBMT
Important dates
Content:
The 12th Educational Course of the LWP
Educational Event of the CMWP
Joint Educational Event of the CMWP and the CTIWP
Joint Educational Course of the CQLWP and the IDWP
Inborn Errors Autumn Meeting

The 12th Educational Course of the Lymphoma Working Party

‘Treatment of malignant lymphoma: state-of –the-art and role of stem cell transplantation’

September 21-23 2016 in Dublin, Ireland

Kindly hosted by Elisabeth Vandenberghe from St James’ Hospital.

The meeting was, as in previous editions, a success with over 60 participants and a faculty composed of 17 international experts on lymphoma and stem cell transplantation. The scientific program covered a comprehensive review of the role of stem cell transplantation in the management of patients with lymphoid malignancies, ranging from general topics to disease-orientated talks. In addition to the purely clinical sessions there were some biological lectures, such as the excellent summary of the biology of graft-versus-host-disease and graft-versus-lymphoma effect by Ron Chakraverty, from University College London, and the exhaustive lecture by Olivier Hermine (Hôpital Necker, Paris) on the biology of Mantle Cell lymphoma. From the point of view of clinical management, some of the most controversial topics in the field, such as the role of haplo-identical transplants were reviewed. Not surprisingly, the question on how to integrate new drugs in the management of patients with lymphoid malignancies aroused considerable interest and discussions, after Anna Sureda’s (ICO, Barcelona) excellent talk. This was followed by a stimulating and heated debate on the role of allogeneic stem cell transplant in Hodgkin lymphoma in the era of new drugs, between Anna Sureda and Pauline Brice (Hôpital St Louis, Paris). Last but not least, the LWP is keeping pace with the most exciting advances in the field and we were honoured to have the privilege of enjoying a sensational review of CAR-T cells in lymphoma by Stephen Schuster (Pennsylvania, USA).

Finally, the Educational Course included its traditional Meet the Expert Dinner, which took place this year in the incomparable setting of the Trinity College, Dublin.


Educational Event of the Chronic Malignancies Working Party

“Updates on MPN, MDS, Leukemia Stem Cell Biology and Haploidentical transplantation”

September 24 2016 in London, UK

After the regular business meeting of the Chronic Malignancies Working Party (CMWP) on September 23 2016, Donal Mc Lonal, Victoria Potter and Kavita Raj, all from King’s College in London, created an exciting educational event, the day after in London, on updates on MPN, MDS, Leukemia Stem Cell Biology and Haploidentical transplantation.

After a lecture about current therapeutic strategies in myelofibrosis given by Nicolaus Kröger (Germany), Eric Solary (France) provided an excellent overview about biology, classification and treatment with hypomethylating agents in Chronic Myelomonocytic Leukemia (CMML), followed by a thoughtful insight into the biology of hypoplastic MDS and aplastic anemia and how these diseases can be diagnosed and distinguished by using novel genetic tools given by Austin Kulasekaraj (UK). Brian Huntley (UK) gave an excellent cutting edge presentation of the most recent advances in AML stem cell biology. Dietger Niederwieser (Germany) highlighted in his presentation the importance and the recent results of allogeneic stem cell transplantation in elderly AML patients and emphasized the importance of well designed prospective randomized trials.

The educational event ended with stimulating lectures by Marie Robin (France) and Kavita Raj (UK) who reported about the recent development of haploidentical stem cell transplantation in MDS and MPN and how relapse can be treated and prevented.

More than 70 participants attended the meeting, which was an excellent mixture of basic research and clinical development, which allowed lively discussions between speakers and audience, changing of ideas and concepts in an inspiring atmosphere.

Joint Educational Event of the Chronic Malignancies Working Party and the Cellular Therapy and Immunobiology Working Party

“Come of age … Immunotherapy in Multiple Myeloma”

From September 30 to October 1 2016 in Berlin, Germany

Multiple Myeloma is one of the most frequent malignant hematological disease and is still considered to be incurable. Some patients who received allogeneic stem cell transplantation might be cured by a donor T cell mediated graft-versus-myeloma effect suggesting a susceptibility of myeloma cells to immune-mediated strategies. The field of immunotherapeutic options is rapidly growing and is providing new treatment options for myeloma patients. More than 120 physicians, scientists and health care providers attended this exciting cutting-edge meeting in Berlin to learn about the most recent developments in the field. The faculty consisted of 22 top experts from Europe and the US in myeloma and immunotherapy providing an excellent overview about the current existing and future options of immunotherapy in Multiple Myeloma.

The two-day meeting consisted of 5 sessions dedicated to vaccination and cell based strategies. Innovative cell therapy with innate immune cells such as NK cells and Gamma-delta T cells were also reported as classical T cell therapy after allogeneic stem cell transplantation (DLI). Very promising approaches were presented in a session of genetically modified T cells either by T cell receptor transduction or by CAR –T cells, targeting CD19, cancer testis antigens, such as NY-ESO or antigen expressed on myeloma cells such as BMCA.

Another session was dedicated to the immunological effect of immune modulating drugs, such as lenalidomide, thalidomide or pomalidomide, which may help to increase NK or T cell mediated anti-myeloma efficacy as well as the proteasome inhibitors, which can be also used to prevent GvHD post allografting.

A very promising option is the increasing numbers of monoclonal antibodies, which were presented in a dedicated session. Some of the antibodies are already approved for myeloma treatment in Europe, such as Anti CD38 or Anti SLAM7 antibodies, which possess beside its anti-myeloma activities several immune-stimulating properties, which may increase the anti –myeloma efficacy by immune mediated effects.

These two days was an extraordinarily valuable forum for all participants in learning the most recent development of immunotherapy in multiple myeloma and sharing ideas and challenging concepts within a stimulating atmosphere.


Chiara Bonini (Chair of CTIWP) and Nicolaus Kröger (Chair of CMWP) 


Nikhil Munshi (Boston) in his lecture about Immunopathology of Multiple Myeloma


Aaron Rapoport via video conference about NY-ESO transduced T cells for Multiple Myeloma 

Joint Educational Course of the Complications and Quality of Life Working Party and the Infectious Diseases Working Party

Management of transplant complications – tricks of the trade

October 27-29 2016 in Madrid, Spain

The EBMT Complications and Quality of Life (CQLWP) and the Infectious Diseases (IDWP) Working Parties have joined efforts to offer our fellow members this educational course on the tricks of the trade of the management of transplant complications. Beyond academic classifications and definitions of particular infective and non-infective entities, the course focused on practical management of transplant complications, and offered the participants the opportunity to interact with expert speakers and discuss clinical cases. To these educational goals, the Faculty comprised a multidisciplinary team of experts including ID physicians, microbiologists, virologists, radiologists and pathologists in addition to hematologists and transplant physicians from the CQLWP and IDWP.
 
The course consisted of four educational and two case presentation sessions. The Educational Sessions included Neurological and Pulmonary Complications Session, Gastrointestinal and Hepatic Complications Session, Update on Differential Diagnosis of Transplant Complications and Complications Long-Term and Remedies in the Pipeline.
 
Each topic, with some exceptions, was presented by two speakers, focused either on infectious or non-infectious complications. Neurological complications were presented by Martin Schmidt-Hieber, based on recent German guidelines on central nervous system infectious complications after stem cell transplantation, followed by a lecture of neurologist Klemens Angstwurm focused on non-infective complications, including possibility of GvHD developing within neurologic system. Georg Maschmeyer and Hildegard Greinix undertook the task of presenting pulmonary complications after HSCT, including fungal, viral and bacterial infections, as well as early endothelial and late chronic pulmonary complications developing in the mechanism of GvHD.
 
Diarrhoeic syndromes were presented by Dina Averbuch and Grzegorz Basak. Important recent progress was made in the area of fecal microbiota transplantation, enabling therapy of multi-resistant bacteria of the gut. Malgorzata Mikulska and Tapani Ruutu described liver complications focused on viral infections and hepatic GvHD.
 
Differential diagnosis of transplant complications were discussed by microbiologis David Navarro, radiologist Peter Heussel and histopathologist Isabel Salas. Finally long-term follow-up issues were presented by Diana Greenfield, while current vaccination issues by Dan Engelhard. Novel antimicrobial agents were shown by Per Ljungman and novel GvHD treatments by Daniel Wolff.
 
The 20th Educational Course of IDWP will be held in Poznan, Poland, in 2017. Save the Save!

Inborn Errors Autumn Meeting

4-6 November 2016 in Ghent, Belgium

The annual Autumn meeting of IEWP this year was hosted by Victoria Bordon in Ghent at the Het Pand old university buildings, over a showery Flanders autumn weekend. Around 100 people attended, including participants from Australia, Malaysia, Hong Kong, Brazil, Canada and the USA. On Friday morning the trainee workshop focused on HSCT for metabolic disease, attended by around 50 people, The afternoon was opened by a stellar session on haemaglobinopathies, covering MSD transplantation in the hydroxyurea era, Unrelated cord transplantation for haemoglobinopathies, T-cell depleted haplo-HSCT, Haploidentical transplantation with post-cyclophosphamide approach, Gene therapy for haemoglobinopathies and long-term outcomes of cerebrovascular disease.
A very lively, but interesting session on pharmacokinetics followed, and we finished with a philosophical, yet practical discussion of the definition of Severe Combined Immunodeficiency in the era of newborn screening and modern genomics. 

Saturday began with the formal session on metabolic disease, covering Long Term Outcome of HSCT in Hurler Syndrome, Leukodystrophy outcomes and 30 years’ experience of HSCT for MPS I. The previous gene therapy session has now been integrated into disease-specific sessions. Chronic granulomatous disease and Wiskott Aldrich syndrome were covered in the next session, followed by outcomes of HSCT for emerging diseases – the same session last year has resulted in two publications with a further two manuscripts submitted. After lunch, the session on severe combined immunodeficiency was introduced by an excellent presentation on T cell exhaustion following HSCT – other presentations included longterm outcomes and gene therapy. Steve Holland from NIH, Bethesda gave the Keynote Lecture on Chronic Granulomatous Disease, with interesting insights into x-linked carriers, and potential implications for partial donor chimeras, or recipients of gene therapy.

Sunday morning commenced with a debate about the use of T cell depleted donors versus mis-matched unrelated donors – a lively discussion generated ideas for the development of new guidelines. The meeting concluded with a review of progress on current studies and some new proposals. The informal atmosphere of an IEWP meeting was maintained, with close friendships, and shared goals of developing new treatments to improve outcomes for our patients. The beautiful city of Ghent entertained us each evening including a memorable boat trip, Belgian beer and chocolate.




Steve Holland
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