ASH News Daily - Monday, December 12, 2011 - (Page A-14)
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TRANSFUSION
ALL
The Truth Behind “TRIM”
he goal of our fight against
By david Garcia, Md,
and Shari Ghanny, Md
By BarBara pro, Md
I
ng the early 1980s that inhe ent
r sitsandard “kill-all” drugs to “sparebe
recogniz
T
ks related to transfusions began to
me” targeted agents have been most
, with the need for eval-
uation of transfusion practices. More
r last few decades. Also, as patients
o the metabolic and biochemical
changes related to storage of blood
products; the clinical significance
of these alterations is now being explored.
In Part I
ci e Education Program session,
at 7:30 a.m. and again at 2:00 p.m.
Blood,” we le rned about
on-related
TRIM), wh ch refers
nflammatory
and
transfu-
immunomodulation
o the proimmunosup--
cancer is finding the MELTtransfusion-relat
d nfections dur-
t wasn’t until the emergence of
ing (most-effective-least-toxic)
of the focus of cancer research in the
ecently, awareness has been drawn
ber of issues due to treatment-related
short- and long-term toxicities
and look back and ask ourselves:
How can we make it better? Is there
increased efficacy
a sweet spoft of the transfusion mediand
minimal toxicity? This morning
“Adverse Complications of Stored
in Elizabeth Ballroom EFGH, Man-
scihester Grand Hyatt San Diego, Dr.
( Adele Fielding, Univer tsity College
i London, will chair an Education Prop
essive consequ nces of RBC and
platel t tran fu io s. Dr. Craig Morrcytic
Leukemia,” outlining the most
cal Center, o ened the ses ion by
examini g platelet storage lesions.
He For pediatric ALL the good news is
platelets and their ability to upregulcally
with five-year rates exceeding
ions, as well as an increase in plateet-derived
immune mediators seen
gram session titled “Current Management
Issues in Acute Lympho-
ell, University of Rochester Medicurrent
and pressing issues in the
treatment of ALL.
discussed the dynamic nature of
that survival has increased dramati-
ate MHC expression during infect
90 percent. The bad ews is that suclcess
has come with a price. Chronic
during platelet storage. According to
Dr. Morrell: “… Platelets represent
an important part of a continuum bet
only a few of the many issues we are
hey are inseparable processes that
health issues,
secondary cancers,
and significant emotional hurdles
for both patients and caregivers are
ween inflammation and thrombosis;
t left to deal with. Dr. Leslie Robinson,
affect each other. Therefore, when
ansfusion,-
performing a platelet
ifto irsm iation o
St. Jude Children’s Research Hospital,
will present the mos tr current i
key issues associated
what is being infused are inflammatity
in childhood ALL survivors.
diator of thrombosis.”
mportant to keep in mind that
with early morbidity and mortal-
ory cells as well as the cellular meMost
importantly, based on recent
findings, she will provide recomchair,
Dr. Ka ina Yazdanbakhsh,
New York Blood Center, discussed
iprove long-term outcomes.
directions for interventions to immmunoregulation
in response to
red What about adult ALL? The good
blood cell transfusions. According
to Dr. Yazdanbakhsh, “under
storage, the RBCs undergo a number
of biochemical and biophysical
changes and release potentially hazardous
materials that may have adverse
effects including perturbations
i JAK2
that normally dampen inflammation
in the transfused susceptible
host … Characterizing host immune
cells that are directly affected by the
storage lesion may lead to identification
of host factors that predispose
certain patient groups to the adverse
effects of RBC transfusions.”
n the immunoregulatory networks
«« From Page A-12
sity Hospital, Atlanta, GA, ended the
session by discussing vasoregulatory
effects of blood products in response
to increased storage intervals
prior to transfusion. He discussed
the process of “INOBA” (insufficient
nitric oxide bio-availability) whereby
the eosinophilic disorders, molecularly
defined as PDGFRA, PDGFRB,
and FGFR1-associated neoplasms.
Dr. James W. Vardiman from the
University of Chicago, indicates
that the promise of future targeted
therapies akin to imatinib played a
role in devising the 2008 WHO Classification
system. While JAK2 mutations
were at once enlightening,
they likely represent just the first
piece of a very elaborate mosaic.
Dr. John Roback, Emory Univer-
Dr. Landau indicated no relevant
conflicts of interest.
003192_sgn35_adc_and_fa2.indd 1
news is that there are many new
therapies; the bad news is that none
of them are fully effective at control-
The second speaker and session
mendations for screening and new
G E N E R AT I O N O F
A N T I B O D Y - D R U G
C O N J U G AT E S
E N G I N E E R I N G
T H E N E X T
omes following transfusion of older
based therapies
ignificantly different
is
Efficacy and Toxicity — Is There a Sweet Spot in ALL?
slting this challenging disease. The de-
ored RBCs have decreased ability
tvelopment of monoclonal antibodies
eading to impaired hypoxic vasodiation.
According to Dr. Roback, “We
o produce and release nitric oxid ,
l represents one of the greatest success
l stories in the treatment of hematodon’t
yet know with certainty wheth-
potiion. Thus, moving away from er these RBC changes translate into
s University of Frankfurt, will discuss
c how the introduction of antibodyversus
fresher RBC units.” Certainly
clinical outchanging
the
t live longer, we struggle with a num- Dr. Roback and others in the field will
lrent data on the use of traditional
tanding of the implications and clinil
effects of storing blood.
ead to improvements in our unders
antibodies, Dr. Hoelzer will disccauss
the use of the newer human-
ized anti-CD20 and bi-specific an-
n Part II of the tr nsfusion medine
Education Program session,
“Hematol gy and Transfusion Medipies
in different clinical settings
tibIodies in the treatment of ALL.
c ne i
Sub-Saharan Africa,” we
logic malignancies as it is the ideal will also be addressed.
targeted therapy. Dr. Dieter Hoelzer,
nsfus on medicine in this part of
tsion with an update on the treatment
he opportunity to experience first-
The Philadelph a chromoso
he work being done in this area by ment of clinical
addition to providing the most cur-
c Siome of the challenges related to Mnneap l
the use of antibody-based thera-
learned about the clinical aspects of minimal
tra Dr. Fielding will conclude the ses-
e is the
translate into low expendia
t outcome for patients with ALL. In mos common cytogenetic abnormalciity
a sociated with adult ALL. Before
ne strategies used in Africa, where
c tihe introduction of yrosine kinase
mes
ures on the health-care system. Dr.
to chemotherapy and short survival
ASH NEWS DAILY
ASH NEWS DAILY
Monday, December 12, 2011
Saturday, December 10, 2011
Troy Lund, University of Minnesota,
spiecific ToKiIss has resulted not only in
rates. Treatment with BCR-ABL,
began the session by
exploring the challenges of diagnosi
better long-term outcome but also in
nant hematologic disorders in SubSaharan
Africa. “While challenging,
toxicity. Dr. Fielding will
he world. Many of us may not have working in Africa gets you to practice
t of Philadelphia-p sitive (Ph+) ALL.
hand the organization and managetransfusion
medi-
review a number of important issues
such as the role of monotherapy with
t TKIs in select patients, the role of altransplantation,
and blood smear. While we cannot
cure and mechanisms of resistance. Rean
impact on the common ones …
he fu damentals – history, exam,
logeneic stem cell
any d agnoses, we can have
vil conflict and unstable economic we also have the o portunity to not
t iinhibitors (TKIs), Ph+ ALL carrie
t poor prognosis with poor r sponse
flicts of interest.
sults of ongoing studies with novel
agents will also be presented.
Dr. Pro indicated no relevant con»»
TRIM Page A-15
higher complete remission rate and
ng and treating benign and malig-
To learn more about our ADC
technology, see our medical affairs
representatives at booth 129
Table of Contents for the Digital Edition of ASH News Daily - Monday, December 12, 2011
ASH News Daily - Monday, December 12, 2011
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