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By Janice Staber, MD

There have been years when the hemostasis and thrombosis community might have felt a little left behind at the ASH annual meeting. However, here in Orlando, sessions on hemostasis and thrombosis were discussed front and center. From the stimulating Friday Scientific Workshop on the Interplay Between Coagulation and Malignancy, to the Ernest Beutler Lecture on Monday afternoon, hemostasis and thrombosis sessions filled the 61st ASH Annual Meeting program. After attending many of the sessions, I was able to reflect on these invigorating few days, and I had an opportunity to get the impressions of ASH President Roy Silverstein, MD, of this year’s program in hemostasis and thrombosis.

Dr. Silverstein highlighted the Friday Scientific Workshop on the Interplay Between Coagulation and Malignancy as a session “worth going to.” This session emphasized multiple aspects of the coagulation pathways and how they relate to myeloproliferative neoplasms and tumor progression. Jeffrey Zwicker, MD, noted, “This is the first time we are holding this workshop, and I think it will be a great way to foster collaborations and research in the field.”

Dr. Silverstein pointed out a new opportunity this year: Saturday’s Hemostasis and Thrombosis Poster Walk for Trainees. Trainees were able to sign up (at no cost) to view six pre-selected posters, joined by leaders in the field and the poster presenter, allowing them to ask questions in an environment that is different than the norm. At the end of the walk, the trainees regrouped and summarized the posters and the overall experience, which Dr. Silverstein described as a “high-touch” encounter with faculty where trainees could learn how senior knowledge leaders approach posters.

A session titled Balancing the Scales: Management of Patients at Risk of Bleeding and Clotting in the Acute Care Setting was presented on both Sunday morning and Monday afternoon. Presenter Jean Connors, MD, pointed out that “in hospital practice and patient care, needs can change hourly.” Dr. Connors discussed the balance of bleeding and clotting in patients with cancer. Her suggestion for these patients is to “prioritize the risks, and not focus on balancing the risks.” Meanwhile Flora Peyvandi, MD, PhD, discussed the balance required in the diagnosis and management of acquired bleeding disorders. Her talk highlighted the paucity of adequate treatments for these patients. Finally, Frank W.G. Leebeek, MD, PhD, presented the balance of bleeding and clotting associated with left ventricular assist devices. Altogether, this was an engaging session that tackled challenging situations in hemostasis and thrombosis.

At the Special Symposium on the Basic Science in Hemostasis and Thrombosis, David Lillicrap, MD, Subbian Ananth Karumanchi, MD, and Martha Sola-Visner, MD, each presented on their pioneering research, including the interplay between von Willebrand factor (vWF) and factor VIII, vascular endothelial growth factor signaling in pre-eclampsia, and the uniqueness of neonatal megakaryopoiesis, respectively. Dr. Lillicrap stated that he is most ex- cited about “the growing appreciation for the relationship between these two coagulation factors [vWF and factor VIII], which is critical to maintaining a normal hemostatic response, and that alterations of either protein can result in bleeding or

thrombotic pathologies.” Additionally, he noted the biggest question remaining in this area: “Remark- ably, 30 years after FVIII was cloned, we are still unclear about important details of its cellular site of synthesis. Why, for example, are specific types of endothelium involved in FVIII production (i.e., lymphatic endothelium), and why don’t most endothelial cells make both FVIII and vWF?”

On Monday, the ASH Networking Reception for the Hemostasis and Thrombosis Community occurred after the Special Symposium. Dr. Silverstein said the most important thing to do for this reception was simply to “show up,” and many did. The reception allowed junior faculty to meet senior colleagues in a “low-key” setting.

What an electrifying time in hemostasis and thrombosis. I can’t wait for what’s to come!        

 

Dr. Staber indicated no relevant conflicts of interest

 

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