ASH 2021 Plans a Hybrid Format—With COVID-19, CAR T, and Health Equity on the Agenda

In recent weeks, the scientific meeting circuit has crept back to life from the COVID-19 pandemic. But the biggest test to date will come this weekend in Atlanta, when the 63rd American Society of Hematology (ASH) Meeting and Exposition gathers December 11-14 at the Georgia World Congress Center, with a virtual format option for those who prefer to participate remotely.

Organizers do not expect the meeting to draw the 30,000 attendees who descended on Orlando, Florida, in 2019 for the last in-person ASH gathering. How many will see the science in person—and catch up with colleagues after nearly 2 years—is anyone’s guess, with the Omicron variant throwing a late curveball into everyone’s plans. The ASH website states that both in-person and online registration “remains strong.”

ASH President Martin S. Tallman, MD, who is professor of medicine at Weill Cornell Medical College and the chief of the Leukemia Service at Memorial Sloan Kettering Cancer Center in New York City, said the decision to hold the hybrid event was made with careful consideration, based on surveys of ASH members.

“While we do not expect a pre-2020 level of attendance, there is still a significant portion of the community that is enthusiastic about a return to in-person meetings, and we are confident that we can deliver that experience in a safe and thoughtful way,” Tallman wrote in a premeeting message that appeared in The Hematologist.

ASH organizers are taking precautions to keep attendees safe. Proof of vaccination is required before attendees can travel to Atlanta, and masks must be worn. No on-site registration is permitted.

Therapeutic Advances, Led by CAR T-Cell Therapy

There’s plenty of great science to draw people to Atlanta, led by results from multiple trials that examine the use of CAR T-cell therapy in second-line or even first-line use in the treatment of large B-cell lymphoma (see related article).

ASH organizers also highlighted presentations by L. Elizabeth Budde, MD, PhD, of City of Hope, who will present phase 1/2 results for mosunetuzumab for patients with relapsed or refractory follicular lymphoma who have had at least 2 lines of therapy, and phase 3 results from Hartmut Goldschmidt, MD, of Heidelberg Hospital, on adding isatuximab to lenalidomide, bortezomib, and dexamethasone for patients with newly diagnosed multiple myeloma.

Noteworthy therapeutic results to be presented at ASH include:

• Early phase 3 results from SEQUOIA, comparing the Bruton tyrosine kinase (BTK) inhibitor zanubrutinib (Brukinsa) vs bendamustine plus rituximab in patients with treatment-naïve chronic lymphocytic leukemia (CLL)/small lymphoyptic lymphoma (SLL) with del(17p).
• Among many results being presented involving the anti-CD38 monoclonal antibody daratumumab (Darzalex) is a real-world data study, which applied scenarios from the MAIA and SWOG S0777 trials to deidentified electronic health record information from the Flatiron Health database. Led by Rafael Fonseca, MD, of Mayo Clinic Arizona, this study accounts for patient attrition.
• The annual ASH-FDA joint symposium on newly approved therapies is set for Monday at 10:30 am.

Effects of COVID-19 and Vaccines

Last year’s online meeting came days before FDA granted Pfizer the first emergency use authorization (EUA) for a COVID-19 vaccine, and the big question was whether patients with blood cancers and disorders should take it. Not only was the answer yes, but they should get at the front of the line, experts said. Even if the response was minimal, it was better than nothing.

Now, 21 months into the pandemic, investigators will present data to answer questions on blood disorders, COVID-19, and vaccines:

• Lisa K. Hicks, MD, MSc, of St. Michaels’s Hospital in Toronto, will present COVID-19 registry data on the risks of hospitalization and death among patients with blood disorders;
• Pinkal Desai, MD, MPH, of Weill Cornell, will discuss predictors of outcomes among patients with acute leukemia, myelodysplastic syndrome, and COVID-19;
• Fuad El Rassi, MD, of Emory, will examine data on COVID-19 and sickle cell disease; and
• a pair of abstracts being presented back-to-back on Saturday afternoon by Jil Rotterdam, of Heidelberg University, andAkriti G. Jain, MD, of Moffitt Cancer Center, will examine how patients with different blood disorders respond to mRNA vaccines.

A basic science abstract that Jacob G. Ludington, MD, PhD, of Beth Israel Deaconess Medical Center, Boston, will present during the plenary session will examine how a mechanism associated with SARS-CoV-2 can lead to blood clots.

And with Atlanta being home to the CDC, the public health agency’s director, Rochelle Walensky, MD, MPH, will lead an event billed as a “Grassroots Network Lunch” on Saturday at the Omni Atlanta Hotel.

Health Equity and Disparities

The pandemic has brought disparities in cancer care and outcomes into focus, and multiple sessions at ASH address the effect on patients with blood cancers and disorders. A group of these abstracts were highlighted in a press preview call by Tallman.

Lori Muffly, MD, of Stanford Medical Center, will present data Saturday on disparities in enrollment in clinical trials involving adolescents and young adults with acute lymphoblastic leukemia (AML). “In addition to disparities in outcome, there are also disparities simply in enrollment onto clinical trials,” said Tallman. “It's found that 40% of adolescent and young adults in the United States with AML are Hispanic and 7% are Black.”

However, fewer Hispanic patients were enrolled on a major clinical trial than are represented in the US population—which was not a complete surprise, since the trial was not even available in several states with high numbers of Hispanic patients.

Saturday will also bring the first results of the PROMISE Study, which uses screening for monoclonal gammopathy to identify individuals at high risk of multiple myeloma and has the largest cohort of Black enrollees, a group at high risk of the disease.

A special scientific session on race and science is scheduled for Saturday at 4 pm.