Boris V. Afanasyev
R. M. Gorbacheva Memorial Institute of Children Hematology, Oncology and Transplantation, Chair of Hematology, Transfusiology and Transplantology, Pavlov First St. Petersburg State Medical University, L. Tolstoy St. 6-8, 197022, St. Petersburg, Russia.
SummaryIn September 2017, St.Petersburg hosted a regular meeting which was dedicated to the issues of hematopoietic stem cell transplantation and related problems. Special attention was drawn to application of novel targeted drugs in treatment of lymphoproliferative diseases, especially, Hodgkin’s disease treated by means of brentuximab, and more recently, the lymphocyte apoptosis inhibitors (PD1 inhibitors). When treating acute myeloid leukemias with tyrosine kinase inhibitors (TKIs), a novel drug Sorafenib (an FLT3 inhibitor) is now introduced.
A strategy of chronic myeloid leukemia (CML) management and, an opportunity of their stoppage upon a long-term molecular remission were also discussed at the meeting. In chronic myeloproliferative disorders, drugs inhibiting oncogenic JAK kinase (e.g., ruxolitinib) are actively implemented. Upon treatment of acute lymphoblastic leukemia and other lymphoproliferative disorders, a number of monoclonal antibodies (e.g., rituximab or blinatumomab) are widely introduced, along with conventional cytostatic treatment protocols.
Some reports concerned new approaches to allogeneic HSCT, i.e., from a haploidentical donor, thus, together with optimal GHVD prophylaxis, results into clinical outcomes comparable to those achieved with unrelated HLA-compatible transplants. Several reports were dedicated to GVHD prophylaxis by means of cyclophosphamide post-transplant.
The issues of immune therapy in leukemias were discussed as a result of clinical implementation of specific recombinant cytotoxic antibodies and gene-modified T cells with chimeric antigens which are potentially able to destroy malignant cells in some oncohematological diseases.
A separate mini-symposium dedicated to gene therapy and outlooks for gene editing using some known enzyme systems (e.g., CRISP/Cas9 and TALEN), along with problems of legal regulation and cellular therapy. Moreover, a special session was performed for medical nurses who discussed urgent tasks and functions of nursing staff at the HSCT departments and intensive therapy.