Professor Shen Zhixiang: Changes in the field of hematological oncology and suggestions for young doctors The 7th International Summit Forum on Anti-Leukemia and Lymphoma

Yimaitong: What major innovations have been experienced in the field of hematological cancer treatment in recent decades?

In the era when the older generation of academician Wang Zhenyi was the director of the department, the prognosis of patients with hematological tumors was very poor, and the survival period was not more than half a year
.
In the past 20 years, the field of hematological oncology has undergone earth-shaking changes
.

First of all, the diagnosis of hematological tumors is more clear, such as the myelodysplastic syndrome (MDS) proposed in the 80s of the 20th century, the diagnosis was very "confusing" at that time, but with the further understanding of the peripheral blood characteristics of the disease, bone marrow smear and biopsy, and chromosomes and genes, its diagnosis is now very clear
.

Second, the remission criteria for hematological tumors are more refined, for example, in the past, patients with acute leukemia were considered complete remission (CR) when the bone marrow smear blasts were less than 5%, and now the more effective response indicator - minimal residual disease (MRD) is less than 10-4 or ^10-5 is MRD negative, and its degree of remission is deeper
.

In addition, the research and development of new drugs for hematological tumors has advanced by leaps and bounds, such as the treatment of B-cell lymphoma due to the qualitative leap of rituximab targeting CD20; The treatment pattern of acute myeloid leukemia has also undergone drastic changes due to targeted new drugs such as IDH inhibitors and BCL2 inhibitors.
The development of hematopoietic hematopoietic stem cell transplantation has increased the chances of
transplantation in patients with hematological tumors.

In short, with the development of overall science, the progress in the field of hematological cancer is very obvious, and the remission and prognosis of hematological cancer patients have been significantly improved
.

Yimaitong: As you said, the field of hematology and oncology has made remarkable progress and China's hematology industry has made steady progress, so what advice and expectations do you have for the younger generation of doctors in the field of hematology?

While scientific development has brought progress, it has also had an impact
on the practice model in the field of blood.
First of all, nowadays, the rapid development of various internal medicines and the frequent updating of knowledge, compared with the previous generation of hematologists who need to master the knowledge of various internal medicines, today's hematologists are relatively focused on updating
knowledge in the field of blood.
Secondly, the subspecialty classification of hematology is more detailed, such as leukemia, lymphoma and coagulation, etc.
, and the corresponding subspecialty may not be able to master the knowledge of the entire field of hematology after many years of practice
.
Moreover, similar to American doctors, domestic doctors increasingly rely on clinical guidelines rather than clinical experience
when treating patients.

In the face of the above problems, young doctors in the field of hematology should first strengthen basic training, go to the multi-department of hematology subspecialty for rotation, not only master the diagnosis and treatment process of hematological neoplastic diseases, such as leukemia and lymphoma, but also master the diagnosis and treatment mode of non-neoplastic diseases, such as coagulation disorders; Secondly, while emphasizing the guidelines, young doctors should pay more attention to the patient's medical history, physical examination, laboratory tests, and even psychological changes to formulate a complete treatment plan, improve the quality of medical care, and help patients better relieve pain
.
All in all, although the development of science has brought certain "adverse reactions" to young doctors, young doctors can grow up healthily only after overcoming it through their own efforts and medical practice
.

Professor Shen Zhixiang

• Tenured professor, professor of internal medicine, chief physician and doctoral supervisor of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine

• Former Chairman of the National Society of Hematology, Chinese Medical Association

• Deputy Editor-in-Chief of Chinese Journal of Hematology and editorial board member of Chinese Medical Journal (English Edition) and other journals

• He has published more than 100 papers and monographs in domestic and foreign journals, edited eight monographs such as "Malignant Hematological Diseases", "Lymphoma", "Concise Clinical Hematology" and "Progress in Hematology Research", and participated in the compilation of more than 10 monographs

• He has won the second prize of the National Natural Science Award, the third prize of the Science and Technology Progress Award, the second prize of the Chinese Medical Science and Technology Award, the second prize of the Shanghai Medical Achievement Award, the third prize of the Medical Achievement Award, the third place in the number of citations of a single international paper in 1999, the first prize of the Chinese Medical Science and Technology Award in 2004, the first prize of the Shanghai Medical Award in 2004, the second prize of the National Natural Science Award in 2004, and the first prize of the Shanghai Science and Technology Award in 2006

• He has been engaged in clinical medicine and clinical research in internal medicine and hematology for a long time, especially in the field of hematologic malignant tumors, hemocoagulation diseases, and severe anemia, and has accumulated rich clinical practice experience