The journey is long, the struggle is timely——CSCO Autologous Transplantation Working Group 2022 Tour (Suzhou Station) was a complete success

On October 17, 2022, the "CSCO Autologous Transplantation Working Group 2022 Tour - Suzhou 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 National Clinical Research Center for Hematological Diseases and the First Affiliated Hospital of Soochow University was successfully held
online.
Professor Ma Jun of Harbin Institute of Hematology and Oncology, Professor Zhu Jun of Peking University Cancer Hospital, Professor Wu Depei of the First Affiliated Hospital of Soochow University served as the chairman of the conference, and Professor Li Caixia of the First Affiliated Hospital of Soochow University served as the executive chairman
of the conference.
At the same time, well-known experts in the field were invited as speakers and commentators to discuss the development status and progress
of autologous hematopoietic stem cell transplantation (ASCT) in China.
This article has compiled the key contents of the conference for the readers
.

Opening remarks

At the beginning of the meeting, Professor Li Caixia, Executive Chairman of the Conference, presided over the opening ceremony and extended a warm welcome
to all participants.
Afterwards, the chairmen of the conference, Professor Ma Jun, Professor Zhu Jun and Professor Wu Depei delivered opening speeches
in turn.
Professor Ma Jun said that the subspecialty of hematology lymphoma of the First Affiliated Hospital of Soochow University has developed rapidly under the leadership of Professor Wu Depei and Professor Li Caixia, especially hematopoietic stem cell transplantation as the characteristics and focus of the Department of Hematology of the First Affiliated Hospital of Soochow University is at the top level in China, and hopes to continue to maintain the tenacity of struggle and contribute to the integration
of ASCT in China and the international ASCT level 。 Professor Zhu Jun said that the CSCO Autologous Transplantation Working Group 2022 Tour aims to further promote the development of ASCT in China with the help of the strength and platform of national hematologists and bone marrow transplantation professionals, so that suitable patients can choose ASCT at the right time as an effective treatment method to benefit patients
.
Professor Wu Depei said that hematological tumors are more sensitive to radiotherapy and chemotherapy, and the larger the chemotherapy dose, the better the treatment effect, the longer the survival time of patients, and ASCT is born
.
After decades of development, ASCT has become an important therapeutic technology, and it is hoped that ASCT will continue to flourish
in the future.
Finally, I wish this meeting a complete success!

Professor Li Caixia served as the officiator of the opening ceremony

Professor Ma Jun delivered an opening speech

Professor Zhu Jun delivered an opening speech

Professor Stephen Wu delivered an opening speech

Academic session

After the opening ceremony, an academic session followed
.
The first part of the academic report was chaired by Professor Zhu Jun
.

Professor Zhu Jun served as the host of the first academic report

Professor Ma Jun gave a report
on the topic of "Current Status and Prospect of Autologous Hematopoietic Stem Cell Transplantation in China".
This report counts a total of 5,221 ASCT cases reported by 211 centers in 29 provinces and cities in China in 2021, of which 439 cases of ASCT in Jiangsu Province, where Suzhou is located, is in the middle of
the country.
Compared with European and American countries and Japan, the total number of ASCT cases in China is small, the proportion of ASCT as salvage treatment is low, and the number of cases of secondary transplantation is small, and ASCT in China still has a lot of room
for development.
In terms of the age distribution of patients undergoing ASCT, the proportion of lymphoma patients aged < 10 years and >65 years < 1%, which is far from<b23> the United States (>30%).
In terms of ASCT utilization, there were 2443 patients with ASCT for the first time in lymphoma, accounting for 2.
4%, and 2113 patients with myeloma, accounting for 11.
3%, which is still a low
proportion.
Professor Ma Jun concluded that the degree of ASCT development in China is insufficient, and high-level evidence-based medical evidence is lacking
.
In the future, we must catch up, strive to cultivate professionals and teams, and carry out more high-quality clinical studies
suitable for the Chinese patient population.

Professor Ma Jun gave a report

The discussion session was chaired by Professor Wu Depei, and the panelists, Professor Hu Jianda of Union Hospital Affiliated to Fujian Medical University and Professor Shuang Yuerong of Jiangxi Provincial Cancer Hospital, focused on "Why is the number of patients undergoing ASCT in China so small compared with foreign countries", "Why is the ratio of the number of patients undergoing ASCT in China to the number of patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) so different from that of foreign countries", "What subtype of patients are recommended for secondary ASCT", " How to use the combination of CAR-T and ASCT" and "the selection and use of drugs in the post-transplantation maintenance treatment stage" were discussed in depth, and the academic atmosphere was strong
.

The second part of the academic report continued to be chaired by Professor Yan Hua of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine
.

Professor Yan Hua served as the host of the second session of the academic report

Professor Hu Shaoyan of the Children's Hospital of Soochow University gave a detailed interpretation
of "Progress of HSCT in Children ALL".
Professor Hu Shaoyan said that at present, the treatment of children with acute lymphoblastic leukemia (ALL) in China has developed rapidly, and the 5-year overall survival (OS) rate has reached more than 90%, but recurrence is still the main factor
restricting the prognosis of children with ALL.
The use of transplantation in pediatric ALL patients is mainly for high-risk and relapsed patients, and transplantation
is recommended as soon as possible after remission in high-risk patients.
The timing of transplantation should focus on minimal residual disease (MRD), which can reduce recurrence rates after MRD is negative
.
At present, reinduction consolidation therapy, CAR-T cell therapy, radiotherapy, targeted therapy, etc.
can be used as effective methods
to turn MRD negative in patients with refractory/recurrent B-ALL.
HSCT effectively reduces the recurrence rate of ALL in children and improves prognosis, but recurrence after transplantation remains an insurmountable gap
.
Understanding the mechanism of recurrence after transplantation, clarifying the risk factors for recurrence before transplantation, and giving early intervention can effectively reduce the recurrence rate
after transplantation.
At present, there is still no unified treatment standard for post-transplantation recurrence in children, and it is called for the establishment of an early intervention system after recurrence to further improve the success rate
of transplantation.

Professor Hu Shaoyan gave a report

Professor Yang Yanli of the First Affiliated Hospital of Bengbu Medical College and Professor Hua Haiying of the Affiliated Hospital of Jiangnan University participated in the discussion session, under the chairmanship of Professor Li Caixia, and discussed the issues of "whether to use ASCT as a consolidation therapy for intermediate-risk children with ALL", "What pretreatment regimen should be selected when ALLO-HSCT is performed in children with relapsed refractory (R/R) ALL", and "Is there a better means to protect children's reproductive and reproductive function at the same time of treatment"
。

The third part of the academic report continued to be chaired by Professor Bai Ou of the First Hospital of Bethune of Jilin University
.

Professor Bai Ou served as the host of the third session of the academic report

Professor Wu Xiaojin of the First Affiliated Hospital of Soochow University gave a detailed interpretation
on the topic of "Autologous hematopoietic stem cell transplantation for the treatment of non-Hodgkin lymphoma".
Professor Wu Xiaojin first mentioned that in the era of individualized and targeted therapy for lymphoma, high-dose chemotherapy and ASCT still play an indelible role
in disease control.
ASCT plays an important role in the treatment of high-risk patients, and domestic and foreign guidelines recommend first-line ASCT for consolidation therapy in young patients with high-risk diffuse large B-cell lymphoma (DLBCL), and ASCT can also be used as a standard rescue consolidation therapy strategy to rescue sensitive
patients with relapsed or primary refractory DLBCL.
Subsequently, Professor Wu Xiaojin introduced the research data of ASCT in lymphoma patients at his center, including the application of busulfan (Bu)-based pretreatment regimen, the comparison of CAR-T and ASCT in the treatment of high-risk lymphoma, the comparison of the efficacy of ASCT between B-NHL and T-NHL, and the survival comparison of biphenotype and non-biphenotype B-NHL
.
Finally, Professor Wu Xiaojin shared the ASCT
of three patients diagnosed with R/R DLBCL, FL and Burkitt lymphoma.

Professor Wu Xiaojin gave a report

Professor Xu Jingyan of Nanjing Gulou Hospital and Professor Yan Feng of Changzhou First People's Hospital participated in the discussion session, under the chairmanship of Professor Li Wenyu of Guangdong Provincial People's Hospital, and conducted wonderful exchanges and discussions
on "whether setipie needs to be reduced for patients with central nervous system lymphoma" and "whether radiotherapy has a place in lymphoma pretreatment".

The fourth part of the academic report continued to be chaired by Professor Liu Weiping of Peking University Cancer Hospital
.

Professor Liu Weiping served as the host of the fourth academic report

Professor Li Jiaqi of the First Affiliated Hospital of Soochow University gave the title of "ASCT Bridging CAR-T in the Treatment of R/R B-NHL", starting from the limitations of the current ASCT salvage therapy, and introduced the application of
ASCT combined with CAR-T cell therapy in R/R B-NHL.
Professor Li Jiaqi said that the long-term prognosis of R/R B-NHL patients is poor, and the standard second-line rescue therapy has limited
rescue value.
Since CAR-T cell therapy was put into clinical application, it has a significant effect in the second-line treatment of R/R B-NHL and above, and significantly improves the survival prognosis
of patients 。 In addition, ASCT bridging CAR-T may further improve the treatment effect of CAR-T, the results of the research of Professor Li Jiaqi's center show that the median follow-up of 7.
5 months, 11 patients with an overall response rate (ORR) of 90.
9%, a 1-year progression-free survival (PFS) rate of 75.
8%, a 1-year OS rate of 75.
8%, up to now, 8 of the 11 patients are still in a state of continuous remission, and the safety of ASCT bridging CAR-T is controllable
。 It can be seen that ASCT bridging CAR-T brings cure hope to R/R B-NHL patients, which is worth further exploration
.

Professor Li Jiaqi gave a speech

Professor Shi Wenyu of the Affiliated Hospital of Nantong University and Professor Xu Ting of the First Affiliated Hospital of Soochow University commented under the chairmanship of Professor Ge Zheng of Zhongda Hospital Affiliated to Southeast University, saying that the efficacy of ASCT bridging CAR-T cell therapy is better than that of CAR-T cell therapy alone, and the results of ORR of more than 90% are gratifying for clinicians and patients
.
Thank you very much to Professor Li Caixia's team for their efforts in the field of lymphoma, and thank Professor Li Jiaqi for her wonderful sharing
.

Summary of the meeting

At the end of the meeting, the chairmen of the conference, Professor Li Caixia and Professor Zhu Jun, made a summary
of the conference.
They said: China's ASCT level and foreign developed countries gap still to be crossed, China's unbalanced development of various regions to be reversed, we have the responsibility to diagnose, take care of, treat the country's hematological cancer patients, in the future we must continue to use practice to prove that work together, hard work, perseverance, in order to surpass the present, write miracles, and achieve the strategic goal
of increasing the overall tumor 5-year survival rate by 15% set by Healthy China 2030 。 We are in a new era, witnessing history and making history; Feeling happy and responsible, tomorrow we must still move forward with confidence and run towards a better future
together.

Professor Li Caixia and Professor Zhu Jun summarized the meeting