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The 17th National Hematology Academic Conference of the Chinese Medical Association was grandly opened in Shanghai on September 23-25, 2022, with the theme of "respect, inheritance, collaboration and innovation", and invited well-known experts at home and abroad to talk about the latest progress
in the field of blood diseases.
In the special session on lymphocyte disease on the afternoon of the 23rd, a number of experts made special reports, and the content was
wonderful.
NK/T-cell lymphoma: from a multi-omics landscape to a combined targeting strategy
Professor Jishi Wang of the Affiliated Hospital of Guizhou Medical University and Professor Song Yongping of the First Affiliated Hospital of Zhengzhou University served as the chairmen, and Professor Zhao Weiying of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine introduced
the molecular typing of NK/T cell lymphoma to targeted therapy with the title of "NK/T cell Lymphoma: From Multi-omics Landscape to Joint Targeting Strategy".
EBV infection is the main causative factor and important disease feature of NK/T-cell lymphoma, NK/T-cell lymphoma is highly aggressive, and currently lacks specific treatment targets and has a poor prognosis
.
Professor Zhao Weiying said that practicing the concept of translational medicine and achieving targeted therapy based on molecular typing is more important
for NK/T cell lymphoma.
Second, the progress of diagnosis and treatment of chronic lymphocytic leukemia
Professor Wang Jingwen of Beijing Tongren Hospital Affiliated to Capital Medical University and Professor Qian Wenbin of the Second Affiliated Hospital of Zhejiang University School of Medicine served as moderators, and Professor Li Jianyong of Jiangsu Provincial People's Hospital (First Affiliated Hospital of Nanjing Medical University) introduced the content of
the relevant guidelines for chronic lymphocytic leukemia (CLL) at home and abroad.
As the efficacy of targeted drug regimens is gradually confirmed in key studies, the recommended status of immunochemotherapy in the latest version of the NCCN CLL/SLL guidelines has further declined, and second-line and follow-up treatment has also deleted chemotherapy and immunochemotherapy regimen recommendations
.
In addition, the guidelines also changed the recommended levels of BTK inhibitors, and the limited treatment recommendation levels of BTK inhibitors and BCL-2 inhibitors were improved
.
3.
Progress in the diagnosis and treatment of peripheral T-cell lymphoma
Professor Tan Yue of the First Affiliated Hospital of Guangzhou Medical University and Professor Xu Caigang of West China Hospital of Sichuan University served as the chair, Professor Zhou Daobin of Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences introduced the topic of "Progress in the Diagnosis and Treatment of Peripheral T-cell Lymphoma (PTCL)", Professor Zhou Daobin said that PTCL heterogeneity is strong, the pathogenesis is complex, the prognosis is poor, and it is necessary to explore a first-line treatment plan
better than CHOP.
At present, small molecule drugs and monoclonal antibodies based on pathogenesis have improved the efficacy
of PTCL.
In addition, immunotherapy is the trend of hematological tumor treatment in the future, but there is still no revolutionary breakthrough, with the gradual development of immunotherapy research, PTCL immunotherapy is worth looking forward to
.
4.
Early diagnosis of EBV-related hemophagocytic syndrome
Professor Zhou Fan of the General Hospital of the Northern Theater of the People's Liberation Army of Chinese the People's Liberation Army and Professor Zhao Xielan of Xiangya Hospital of Central South University served as the presidencyts, and Professor Wang Zhao of Beijing Friendship Hospital affiliated to Capital Medical University introduced the problems related to the early diagnosis of EBV-related hemophagocytic syndrome (EBV-HLH), and Professor Wang Zhao said that EBV-HLH is a life-threatening disease and early diagnosis is the key to
treatment.
Patients with active EBV infection should be alerted to HLH if their symptoms persist and symptoms persist and progressive cytopenia, liver function continues to deteriorate, hypoproteinemia, and ferritin is significantly elevated
.
Early improvement of NK cell activity, sCD25, CD107a, cytokines, EBV-infected lymphocyte subsets is conducive to the early diagnosis and differential diagnosis
of EBV-HLH.
In addition, early use of VP-16 (etoposide) is beneficial in improving the prognosis
of EBV-HLH patients.
However, there is currently a lack of drugs that are consistently effective to clear EBV, and allo-HSCT may be the ultimate cure
.
V.
Progress in the diagnosis and treatment of double-expressed diffuse large B-cell lymphoma
Professor Wang Xin of Shandong Provincial Hospital and Professor Xu Wei of Jiangsu Provincial People's Hospital (First Affiliated Hospital of Nanjing Medical University) served as the presidency, and Professor Niu Ting of West China Hospital of Sichuan University introduced
the diagnosis and treatment of double-expression diffuse large B-cell lymphoma.
Dual expression (with c-MYC and BCL-2 protein overexpression) diffuse large B-cell lymphoma (DE-DLBCL) heterogeneity is strong, and in the era of rituximab, double expression is an independent prognostic factor
.
Initial treatment of DE-DLBCL can be treated with a variety of treatment strategies, such as intensive chemotherapy regimen and transplant consolidation therapy, BTK inhibitors, HDAC inhibitors, XPO-1 inhibitors, etc
.
A Phase 3 randomized controlled study of the HDAC inhibitor sidabenamide combined with R-CHOP in the treatment of the initial treatment of DE-DLBCL is underway and excellent results are
expected.
Relapsed/refractory DE-DLBCL does not significantly improve long-term survival and prognosis even with consolidation transplantation, so new therapeutic target agents still need to be explored
.
VI.
Progress in the diagnosis and treatment of follicular lymphoma
Professor Zhu Zunmin of Henan Provincial People's Hospital and Professor Cui Lijuan of Ningxia Medical University General Hospital served as the presidency, and Professor Zhao Donglu of Harbin Institute of Hematology and Oncology introduced
the topic of "Progress in the Diagnosis and Treatment of Follicular Lymphoma (FL)".
The choice of treatment options for relapsed refractory FL is diverse, but there is still no standardized treatment regimen, and the choice of salvage treatment regimen requires individualized comprehensive evaluation
.
New drug advances include Pl3K inhibitors showing good efficacy and safety in relapsed refractory FL; CD20xCD3 bispecific antibody monotherapy or combination therapy can achieve high clinical remission rate in relapsed refractory FL, the most common adverse reaction is CRS, but most of them are grade 1-2, safe and controllable; CAR-T also exhibits consistently high response rates in relapsed refractory FL, with acceptable
safety features.
7.
Autologous/allogeneic hematopoietic stem cell transplantation treatment strategies in the CAR-T era
Professor Zeng Qingshu of the First Affiliated Hospital of Anhui Medical University and Professor Nong Weixia of the First Affiliated Hospital of Shihezi University School of Medicine served as the chair, and Professor Sang Wei of the Affiliated Hospital of Xuzhou Medical University introduced the treatment strategy
of autologous hematopoietic stem cell transplantation (ASCT)/allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the CAR-T era 。 Professor Sunway said that for patients with B-NHL, it is recommended to combine with ASCT, and for patients with good physical fitness, the strategy of post-transplant CAR-T treatment can be adopted; For patients who are too weak to tolerate transplantation, CAR-T treatment can be followed by transplantation, and if necessary, a secondary CAR-T (Sanming therapy) can be combined
.
In patients with T/B-ALL/LBL, AFTER CAR-T induction to CR, there is a clear benefit from
continued allo-HSCT.
For post-CAR-T portation (ASCT/allo-HSCT) timing, 3 months is recommended as a reference time node
.
VIII.
Progress in the diagnosis and treatment of mantle cell lymphoma
Professor Feng Ru of Nanfang Hospital of Southern Medical University and Professor Wei Zheng of Zhongshan Hospital Affiliated to Fudan University served as the presidencytes, and Professor Yi Shuhua of the Blood Disease Hospital of the Chinese Academy of Medical Sciences introduced
the topic of "Progress in the Diagnosis and Treatment of Mantle Cell Lymphoma (MCL)".
MCL heterogeneity is high, stratified therapy is critical, and high-risk patients have a poor prognosis, and new treatment modalities need to be explored
.
Regimens containing large doses of Ara-C induce ASCT after remission is currently the standard of care for younger patients
.
In addition, the application of CAR-T cells brings new hope to high-risk and relapsed refractory patients; Small molecule targeted drug combination therapy is also the choice of the future, and it is a matter of time before it enters the front line, and more clinical trial results
are expected.
Finally, Professor Yi Shuhua stressed that the current application of Chemo-free protocol needs to be cautious, and more evidence
is needed for low-risk patients.
brief summary
The 17th National Hematology Academic Conference of the Chinese Medical Association - Lymphocyte Disease Group Special Conference was successfully held, which effectively promoted the academic exchanges in the field of lymphocyte diseases in China, promoted the discipline construction and development of blood and lymphoma, and brought more benefits
to patients with hematological tumors.
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