• September
1st World Congress on Controversies in Hematology
Sept. 2-5
Rome, Italy

ISCT Europe Regional Meeting
International Society for Cellular Therapy (ISCT)
Sept. 11-14
Best Western Hotel Villa Carlotta
Belgirate, Italy

International Society for Experimental Hematology (ISEH)
39th Annual Scientific Meeting
Sept. 15-18
Melbourne Convention and Exhibition Center
Melbourne, Australia

12th International Conference on Chronic Myeloid Leukemia - Biological Basis of Therapy
ESH (European School of Haematology) and iCMLf (International Chronic Myeloid Leukemia Foundation)
Sept. 24-26
Grand Hyatt Washington
Washington, DC

American Society for Histocompatibility and Immunogenetics (ASHI)
36th Annual Meeting
Sept. 26-30
Westin Diplomat
Hollywood, Florida

• October
Fraunhofer Institute for Cell Therapy and Immunology
6th International Symposium on Neuroprotection and Neurorepair
October 1-4
Yachthafenresidenz Hohe Düne
Rostock-Warnemünde, Germany

European Society for Medical Oncology (ESMO)
35th Annual Meeting
Oct. 8-12
Milano Convention Centre
Milan, Italy

American Association of Blood Banks (AABB)
2010 Annual Meeting
Oct. 9-12
Baltimore Convention Center
Baltimore, Maryland

International Society of Hematology (ISH)
33rd World Congress
Oct. 10-13
ICC Jerusalem International Convention Center
Jerusalem, Israel

National Marrow Donor Program
2010 Council Meeting
Oct. 14-16
Minneapolis Hilton
Minneapolis, Minnesota

European School of Haematology
8th International Conference
Oct. 14-18
Cascais, Portugal

ISCT Asia-Pacific Regional Meeting
International Society for Cellular Therapy (ISCT)
Oct. 17-20
Phoenix Seagaia Resort
Miyazaki, Japan

Histiocytosis Association of America (HAA)
Oct. 18-20
Boston, Massachusetts

European Society of Gene & Cell Therapy (ESGCT)
18th Annual Congress
Oct. 22-25
Stella Polare Convention Centre
Milano, Italy

• November
World Cord Blood Congress
Nov. 4-7
Marseille, France

Neoplastic Hematopathology Update
Nov. 11-13
The Westin Diplomat Resort & Spa
Hollywood, Florida

• December
American Society of Hematology (ASH)
52nd Annual Meeting
Dec. 4-7
Orange County Convention Center
Orlando, Florida

• 2011
BMT Tandem Meetings
Combined ASBMT and CIBMTR annual meetings
Feb. 17-21
Hawaii Convention Center
Honolulu, Hawaii

• 2012
BMT Tandem Meetings
Combined ASBMT and CIBMTR annual meetings
Feb. 1-5
Manchester Grand Hyatt Hotel
San Diego, California

• 2013
BMT Tandem Meetings
Combined ASBMT and CIBMTR annual meetings
Feb. 13-17
Salt Palace
Salt Lake City, Utah

• 2014
BMT Tandem Meetings
Combined ASBMT and CIBMTR annual meetings
Feb. 19-23
Gaylord Palms
Orlando, Florida

A Word from President John Barrett, MD

Transplant-related mortality
Perhaps not every year, but at least every decade, we can document a slow, steady improvement in transplant-related mortality (this in spite of the fact that the median age of transplant has risen, with its contingent co-morbidities). While we can all identify center-specific developments that have improved the outcome for our patients, in the global perspective there is a general wave front of improvement that has translated into a gratifyingly broad and worldwide reduction in post-transplant mortality. What are the motors driving this improvement? Firstly, we have to thank the contribution of pharmaceutical developments, specifically in the area of antimicrobials and immunosuppression. To old timers, it is still remarkable to be able to rescue patients from aspergillus infections and to have reduced the problem of cytomegalovirus (CMV) from an untreatable pneumonia to battling a polymerase chain reaction (PCR) with preemptive therapy.

But, I would suggest that another important and less definable factor has been the contribution of transplant physician education to creating familiarity with the dozen or so commonest post-transplant complications, bringing the benefits of early diagnosis and the institution of prompt, effective remedies. ASBMT membership surveys have revealed how much our members value guidance in transplant practice, and the Society is dedicated to education through the newly formed Committee on Practice Guidelines and the possibility of developing a transplant handbook. In addition, collaboration with other transplant societies worldwide will help to disseminate and apply the current best treatment approaches. Centers often have a special expertise in managing a particular complication and contrasting center-specific approaches to familiar transplant situations can be very valuable. Exchange fellowships between U.S. and European transplant centers (currently under discussion with the European Group for Blood and Marrow Transplantation) represent one way to help this diffusion of know-how.

More improvements?
While there is reason for congratulation that we have seen transplant-related mortality (TRM) fall over the past 40 years, we should see developments in transplantation in Churchillian terms – “This is not the end, nor is it the beginning of the end, but it is the end of the beginning.” Until we eliminate TRM, both fundamental and applied research is needed to address the twin evils of GVHD and poor immune reconstitution, never forgetting the need to do better to control the malignant disease that we transplant for in the first place. These objectives are still on a horizon, and horizons have the unfortunate property of receding as we advance towards them.

However, there are some short cuts to better success that depend less on science and more on education and changing ingrained perceptions in our referring physicians and in our patients and their families. It is salutary to observe that one-third to one-half of all transplant patients receive their transplant later than ideal. One of the most enduring and dichotomous criteria for predicting stem cell transplant outcome is the pretransplant risk category – “standard risk,” representing, for example, the first remission acute leukemias, and the early stage myelodysplastic syndrome (MDS) where it is reasonable to expect survivals of around 75 percent across the board. When this is contrasted with the much lower survival expectation for more advanced leukemias and MDS, say 40 percent, it can immediately be appreciated that we could improve outcome for the commonest transplant indications by 25 percent if such patients received their transplant at the optimum time. Late referral is perpetuated by the fact that salvage transplants end up doing worse, reinforcing the perception of referring physicians that transplant is a high-risk option that does not reliably control disease. This perception could change if more transplants were performed electively at the optimum moment for successful outcomes.

Reaching and informing referring physicians and their patients about the benefits of earlier transplants is an ongoing challenge. A conference in Chicago hosted by the National Marrow Donor Program (NMDP) will address the question of transplant referral and other logistics at a “Systems Capacity” meeting. The meeting will bring together transplant physicians, advanced practice professionals, nurses, donor centers and hospital administrators to address ways in which we can accommodate an ever-increasing number of transplants and deliver optimum care before, during and after transplant. The reduced workload associated with elective compared with salvage transplants fits well into the strategy of optimizing the transplant resources of the country. Patients and their families can also serve as educators for referring physicians and ASBMT therefore supports patient educational groups, such as BMT InfoNet and nbmtLINK.

Finally, while planning is important, we should remain flexible to rapid changes in direction of health care relating to therapeutic innovations, such as those that occurred with the arrival of imatinib and the subsequent dwindling of transplants for chronic myeloid leukemia. As Robert Burns said, “the best laid schemes of mice and men often go awry.” Indeed, it is to be hoped that simpler treatments will take the place of expensive and risky ones. Meanwhile, our job is to keep striving to improve transplantation and make the best of the technology we have.

-- John