Talents gathered together to climb the academic "peak" of ASCT - CSCO Autologous Transplantation Working Group 2022 Lecture-Lymphoma Special Session (Anhui Station) was a complete success

On October 9, 2022, the CSCO Autologous Transplantation Working Group 2022 Tour - Lymphoma Special Session (Anhui Station), hosted by the Chinese Society of Clinical Oncology (CSCO), CSCO Lymphoma Expert Committee, CSCO Leukemia Expert Committee, CSCO Autologous Hematopoietic Stem Cell Transplantation Working Group, and undertaken by the Department of Hematology of Anhui Cancer Hospital, was successfully held
online 。 The conference invited Professor Ma Jun of Harbin Institute of Hematology and Oncology, Professor Zhu Jun of Peking University Cancer Hospital, and Professor Ding Kaiyang of Anhui Cancer Hospital as chairmen of the conference, and invited well-known experts in the field as speakers and discussants to discuss the current status and practical application
of autologous hematopoietic stem cell transplantation (ASCT) in the field of lymphoma.
This article has compiled the key contents of the conference for the readers
.

Opening remarks

At the beginning of the conference, Professor Wang Xiaopei of Peking University Cancer Hospital presided over the opening ceremony and extended a warm welcome
to all participants.
Afterwards, the chairmen of the conference, Professor Zhu Jun, Professor Ma Jun and Professor Ding Kaiyang, delivered opening speeches
in turn.
Professor Zhu Jun said that the CSCO Autologous Hematopoietic Stem Cell Transplantation Working Group is committed to promoting the standardized application of ASCT in China in lymphoma, leukemia and multiple myeloma (MM) and other malignant hematological tumors, and making up for the gap
between China's ASCT technology level and foreign countries.
I believe that through the unremitting efforts of all colleagues, it will eventually pay off
.
Professor Ma Jun said that the number of patients with ASCT in China has a large gap with Japan, South Korea, Europe and the United States, in order to narrow this gap, we need to continue to make every effort, hoping that this tour can improve the understanding of Chinese clinicians on ASCT and promote the standardized application
of ASCT.
Life is paramount, life is above all else, and we still need to work
hard for lymphoma patients to achieve longer-term survival and achieve higher clinical cure rates.
Professor Ding Kaiyang said that ASCT, as an important intensive consolidation therapy or salvage treatment for lymphoma and myeloma, needs our attention, and hopes that the most commonly used operation method and the latest knowledge of ASCT technology can be brought to hematologists
in Anhui Province through this tour.
Finally, I wish this meeting a complete success!

Professor Wang Xiaopei served as the officiator of the opening ceremony

Professor Zhu Jun delivered an opening speech

Professor Ma Jun delivered an opening speech

Professor Ding Kaiyang delivered an opening speech

Academic session

After the opening speech, the academic session was officially opened, with wonderful content
.
The first session was presided over
by Professor Xia Ruixiang of the First Affiliated Hospital of Anhui Medical University.

Professor Xia Ruixiang served as the host of the first session

Professor Cao Yang from Tongji Hospital affiliated to Huazhong University of Science and Technology gave a detailed report
on the topic of "Lymphoblastic Lymphoma/Leukemia Transplantation Treatment Strategy".
Professor Cao Yang pointed out that the incidence of lymphoblastic lymphoma/leukemia (LBL/ALL) is low, large-scale clinical studies are relatively few, there is currently no unified standard treatment plan, and only some treatment recommendations can be used for reference
.
For LBL, initial remission is critical, and ALL treatment options can be considered, but the jury is still out on which regimen is better, and there is controversy
over whether to perform transplant consolidation after induction therapy and which transplant method to choose.
At present, domestic and foreign studies have shown that compared with chemotherapy alone and/or combined with allogeneic hematopoietic stem cell transplantation (allo-HSCT), ASCT consolidation therapy followed by first-line intensive chemotherapy and ASCT salvage therapy after disease recurrence-induced remission have great advantages in survival and prognosis for LBL/ALL patients, which is worth further exploration
.

Professor Cao Yang gave a report

In the discussion session, Professor Yang Yanli of the First Affiliated Hospital of Bengbu Medical College and Professor Ge Jian of the First Affiliated Hospital of Anhui Medical University discussed "The efficacy and prospect of new targeted drugs for B-LBL", "What prognostic factors need to be considered in addition to bone marrow invasion in LBL patients who have been remission after treatment", and "For B-LBL patients, when the CAR gene copy number still exists after CAR-T treatment, Should ASCT or allo-HSCT be used in the future", and conducted in-depth discussions with Professor Cao Yang, and the academic atmosphere was strong
.

The second session was presided over
by Professor Yao Fusheng of Anqing Municipal Hospital.

Professor Yao Fusheng served as the host of the second session

Professor Wu Guolin of Anhui Cancer Hospital gave a detailed interpretation
of the status of ASCT in the treatment of DLBCL under the mode of immune molecular targeted precision therapy.
In the era of new drugs, ASCT still has a prominent position in the treatment of diffuse large B-cell lymphoma (DLBCL), and many clinical studies at home and abroad have shown that DLBCL with adverse prognostic factors, such as high-grade B-cell lymphoma, double-expressed/tri-expressed, double-shot DLBCL and primary central nervous system lymphoma (PCNSL), may benefit
from first-line ASCT.
ASCT may overcome poor prognosis due to high-risk factors and prolong progression-free survival (PFS) and overall survival (OS).

Domestic and international guidelines recommend first-line ASCT for consolidation therapy
in high-risk DLBCL patients.
The benefit of PFS and OS rates at 3 years was more significant in patients with first-line ASCT compared with second-line ASCT (PFS rate: 93.
3% vs.
58.
7%; OS rate: 93.
3% vs.
59.
2%)
.
However, guidelines and studies indicate that second-line ASCT remains the standard consolidation regimen for chemotherapy-sensitive relapsed refractory DLBCL, resulting in cure
in 30% to 40% of patients.

Professor Wu Guolin gave a report

In the discussion session, Professor Tang Baolin and Professor Kang Tinggan, the First Affiliated Hospital of University of Science and Technology of China, participated in the discussion, and had wonderful exchanges
on topics such as "With the wide application of genotyping, will the status of ASCT in some DLBCL subtypes be challenged by targeted new drugs" and "Early diagnosis and treatment option selection for CD5-positive DLBCL patients".

The third session was presided over
by Professor Zhu Xiaoyu from the First Affiliated Hospital of University of Science and Technology of China.

Professor Zhu Xiaoyu served as the host of the third session

Professor Hu Maogui of Anhui Provincial Cancer Hospital gave a detailed report
on the clinical application of PEG-rhG-CSF in lymphocyte tumor hematopoietic stem cell transplantation (literature interpretation) from three aspects: lympho-related epidemiological data, pegylated recombinant human granulocyte stimulating factor (PEG-rhG-CSF) and hematopoietic stem cell mobilization, and hematopoietic remodeling after hematopoietic stem cell transplantation 。 Professor Hu Maogui pointed out that compared with European and American countries, Chinese lymphoma patients are relatively younger, the incidence of aggressive lymphoma is higher, patients need a stronger combination chemotherapy regimen, and some patients need ASCT for consolidation
.
Subsequently, Professor Hu Maogui interpreted many literature at home and abroad, and concluded that PEG-rhG-CSF can be effectively used for the mobilization and reconstruction of peripheral hematopoietic stem cell transplantation of bone marrow in MM and lymphoma patients, and the efficacy in transplantation and reconstruction is not inferior to or even better than rhG-CSF
.
In addition, PEG-rhG-CSF is more economical
than rhG-CSF for post-lymphoma peripheral hematopoietic stem cell transplantation reconstruction.

Professor Hu Maogui gave a report

In the discussion session, Professor Zhu Taigang of Anhui North Coal and Power Group General Hospital and Professor Song Hao of Anhui Provincial Cancer Hospital actively discussed
with Professor Hu Maogui on "how to grasp the timing of PEG-rhG-CSF use during steady-state mobilization", "the number of days between pretreatment and the start of PEG-rhG-CSF use during hematopoietic reconstruction" and "the safety of PEG-rhG-CSF".

The fourth session was presided over
by Professor Huang Dongping of Yijishan Hospital, Wannan Medical College.

Professor Huang Dongping served as the moderator of the fourth session

Professor Chen Lijuan of Jiangsu Provincial People's Hospital explained in the report "Can ASCT be replaced in the treatment of multiple myeloma", from four aspects: the status of ASCT in MM in the new drug era, the timing of ASCT treatment for MM treatment, the treatment strategy of MM patients suitable for transplantation under the guidance of minimal residual disease (MRD), and the current status of ASCT application in
China-naïve MM patients 。 Professor Chen Lijuan said that in the era of new drugs, the status of high-dose chemotherapy (HDT)/ASCT cannot be replaced, and ASCT is still the first-line choice
for MM treatment.
With the application of monoclonal antibody + proteasome inhibitors (PIs) + immunomodulator (IMiDs) combination induction scheme and the concept of MRD negative in the post-new drug era, late transplantation
can be considered on the basis of full communication for the treatment of standard risk patients and patients with weak physical strength who achieve MRD negative after induction therapy.
The proportion of MM patients in China receiving HDT+ASCT is still very low and needs to be strongly promoted
.

Professor Chen Lijuan gave a speech

In the discussion session, Professor Hu Maogui of Anhui Provincial Cancer Hospital and Professor Wang Yansheng of the Second Affiliated Hospital of Anhui Medical University had a heated discussion
with the guests on issues such as "when high-risk patients reach MRD negative after transplantation, do they need to have sequential double transplantation within half a year".

The fifth session was chaired by Professor Fan Lei of Jiangsu Provincial People's Hospital
.

Professor Fan Lei served as the moderator of the fifth session

Professor Liu Weiping of Peking University Cancer Hospital analyzed a total of 5221 ASCT cases reported by 211 centers in 29 provinces and cities in China in 2021 in the report "Current Status of Autologous Hematopoietic Stem Cell Transplantation in China
".
Professor Liu Weiping pointed out that compared with European and American countries and Japan, the total number of ASCT cases in China is small, and there are only 5 transplant centers with > 100 cases of ASCT transplantation in one year; In addition, the number of secondary transplantation cases in China is small, the age distribution of patients is relatively young, and some transplant centers cannot monitor the number of
CD34+ stem cells in peripheral blood.
It can be seen that ASCT in China still has a lot of room
for development.
At present, ASCT methods are mature, well documented, widely used, and highly accessible, which is worthy of our application
in more patients.
It is hoped that in the future, we can jointly carry out more prospective cohort studies and randomized controlled studies to further explore
the application of ASCT in patients with hematological tumors.

Professor Liu Weiping gave a report

In the discussion session, Professor Ge Hongfeng of Bozhou People's Hospital and Professor Zhong Long of Anqing Municipal Hospital discussed "the choice of chemotherapy mobilization and homeostatic mobilization", "the application timing of granulocyte colony-stimulating factor (G-CSF) after hematopoietic stem cell mobilization", "Precautions for replacing carmustine with bendamustine in the pretreatment stage", "whether maintenance therapy is required and transplantation can be performed in patients with follicular lymphoma grade 3b", and "whether ASCT is feasible in patients with PCNSL patients with unsound limb function" , and had a lively discussion
with Professor Liu Weiping.

Summary of the meeting

At the end of the meeting, Professor Ding Kaiyang, the chairman of the conference, made a summary
of the conference.
Professor Ding Kaiyang said: Thank you to all the experts for bringing us wonderful lectures on the topic of ASCT application in lymphoma and myeloma, and answering in detail the various questions that ASCT may involve in clinical practice
.
It is believed that through this tour, we can further promote the standardized development of ASCT in hospitals in Anhui Province, and help more patients with hematological tumors such as lymphoma and myeloma achieve clinical cure!

Professor Ding Kaiyang made a summary of the meeting