With the COVID-19 pandemic driving yet another science conference to the virtual world, it is fitting that the 62nd ASH Annual Meeting and Exposition officially kicked off today with a virtual fireside chat via live stream featuring none other than Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, and a member of the administration’s coronavirus task force.
The ASH meeting typically fills massive convention centers each December. Each year, 40,000 scientists, clinicians and other healthcare professionals, pharmaceutical and biotechnology executives, media, and communications specialists, gather to share and learn about the latest advances in the blood cancers and other blood diseases, including sick cell anemia and hemophilia
Dr. Fauci and ASH president Stephanie Lee, MD, discussed the impact of COVID-19 on patients with blood cancers. Despite cancer patients being excluded from clinical trials for impending COVID-19 vaccines, Dr. Fauci recommended that patients who are immunocompromised, including blood cancer patients, receive the vaccine when it becomes available. He also said that all healthy people should get the vaccine to create the umbrella effect of herd immunity. Dr. Fauci also said that “we can crush the virus” if billions of people around the globe have access to the vaccine. In the meantime, he stressed it is urgent to continue to practice responsible public health measures like wearing masks and social distancing.
More on COVID-19 and Blood Cancers
The impact of COVID-19 on the treatment of blood cancer patients is also featured in several scientific presentations during the meeting.
One study presented this morning shows that T cells taken from patients who have recovered from COVID-19 have the potential to be used as a treatment to boost the immune response of high-risk patients, such as those with blood cancers. This “off-the-shelf” T-cell treatment is ready to be tested in clinical trials for patients who are hospitalized with COVID-19 and at risk of requiring mechanical ventilation.
The ASH Research Collaborative COVID-19 Registry for Hematology was launched in April to gather data from blood cancer patients around the world who were infected with COVID-19. To date, the registry has gathered information from 656 patients, and analysis of the data supports the consensus that blood cancer patients are, indeed, among the most at-risk of becoming seriously sick from infection with the novel coronavirus. The study presented today shows that one in five patients in the registry died from COVID-19 between April and November. The idea behind the registry is to help researchers track trends such as how COVID-19 treatment has and continues to evolve as well as which age groups and subtypes of disease are most vulnerable to serious illness and death. However, the researchers assert they see no reason, based on their data, to withhold intensive cancer treatment from COVID-19 positive patients with underlying hematologic malignancies.
Racial Disparities in Outcomes
Along with the pandemic, the conference is addressing racial injustice, which permeates every aspect of society and is an especially glaring issue in access to healthcare and patient outcomes.
Two studies presented during the meeting call attention to structural inequities that contribute to worse outcomes for Black and Hispanic patients with blood cancers.
One important study, presented in a media briefing today (and will be the subject of the Plenary Session on Sunday) by a team from The Ohio State University Comprehensive Cancer Center, shows that younger Black patients with acute myeloid leukemia (AML) are more likely to die from their disease than white patients. This was found true even for Black patients who have the NPM1 mutation, which is a subtype of AML that tends to respond better to therapy than other subtypes.
Surprisingly, the authors found these outcomes hold even when the patients are participating in clinical trials, where patients are more closely monitored and there tends to be better adherence to treatment regimens.
Another study presented today by researchers from University of Illinois at Chicago, shows that Black and Hispanic patients with AML who live in socio-economically disadvantaged neighborhoods are at increased risk of death from AML. The study is the first to integrate clinical and disease data with census tract data, including affluence and disadvantage information. The researchers used the term “structural violence” to describe this phenomenon.
Both studies make clear that the medical and science community need to do more to better understand these disparities so the complex and understudied causes can be addressed, including the social, psychological, environmental, policy, interpersonal, institutional, biological, and implicit bias, and the interplay of all of these factors at every level of ecology.
To this end, The Leukemia & Lymphoma Society is committed to supporting its “Equity in Access” research program that aims to advance study of underlying causes of inequitable access to care and identify policies, strategies and interventions that have the potential to reduce inequities and increase access to health care, services and programs for blood cancer patients and survivors. LLS also plans to launch the IMPACT grant program in the spring, bringing clinical trials to underserved populations. Major cancer centers will serve as the “hub” for the trials, with “spokes” out in the community hospital and clinical settings. Further, we are expanding our Myeloma Link program to include all blood cancers, directly connecting Black communities to free information, support and resources.
The ASH meeting continues through Tuesday and in an upcoming blog we will detail more of the scientific sessions, including a focus on emerging immunotherapies such as CAR T-cell therapy and bispecific antibodies, targeted therapies and powerful combination therapies.
Stay tuned and if you are a registered ASH attendee be sure to visit us at our virtual booth.