30 Years of ASH

As most of you know, I like to spend some time in November and December looking at the abstracts for ASH, the American Society of Hematology's annual meeting. Because ASH focuses on blood diseases, there is a lot of research related to Follicular Lymphoma presented at this conference. I like to find abstracts or summaries of research that I find interesting, and after it's over in early December, commentaries from experts (actual experts, not just Cancer Nerds like me) about things that they found significant.

Yesterday, I came across what I thought was a really interesting reflection on ASH. Instead of just looking back at this year's conference, the writer (Dr. John Sweetenham of the UT Southwestern Medical Center in Dallas, Texas) looked at the 30 years he has spent attending ASH conferences, and thinking about how much has changed in that time

I'm in a reflective mood these days (as you'll see next week), so I found it kind of a fascinating trip through time. For one thing, the ASH organizers have smartened up a little. Dr. Sweetenham's first ASH in 1990 was in Boston. More recently, they're held in Orlando, Atlanta, and San Diego. Now, I'm a Boston native, and I love my city, but Boston in December isn't always fun. I can't help thinking that there's a connection between advances in Lymphoma research over the last 10 years, and Lymphoma researchers figuring out that they should meet someplace warm in December. It's a sign of how far the field has advanced recently.

More interesting is how he describes those changes in Lymphoma research. In 1990, the Immunotherapy research was focused on things like attempts at a cancer vaccine, and targeting the CD19 protein. It wouldn't be until 1997 that Rituxan was approved by the FDA, and the world of Follicular Lymphoma treatment changed forever. Interestingly, as he points out, Rituxan targets the CD20 protein on Lymphoma cells. It was only recently that researchers found something that targets CD19 -- that's CAR-T, another potential game-changer for us.

Also interesting is Dr. Sweetenham's observation that the field has not paid enough attention to what he calls the "bigger-picture, societal impacts" of those new and better treatments. This is a discussion that many oncologists would like to have. As wonderful as something like CAR-T could be for our future, it is very expensive. Other, newer treatments are also expensive. He wishes there was more discussion at the meeting about the impact this will have on patients, and on the U.S.'s healthcare model in general. (I certainly agree -- great treatments don't mean much if patients can't afford them, and an extended life that is made worse by financial ruin isn't necessarily a great life.)

There's been quite a bit of change in 30 years, and maybe a lot that has stayed the same. I appreciate Dr. Sweetenham's reflection. It's given me lots to think about, too....