By Jim Omel
Grand Island, NE
It is interesting that my favorite moment at the 56th American Society of Hematology (ASH) Annual Meeting corresponds quite directly with my least favorite moment. Myeloma therapy has undergone an unprecedented change the last decade and new therapies have extended our median survival to much longer than it was ten years ago. The enthusiasm surrounding treating myeloma is enormous. You could feel it at ASH! There were an amazing 855 abstracts dealing with myeloma, an unprecedented number. My favorite moment at the entire meeting occurred while sitting in a huge convention center room with literally thousands of other attendees. The room was packed with people listening to Professor Jesus San-Miguel of the University of Navarra, Pamplona, Spain, delivering the prestigious Ham-Wasserman lecture. As I turned and looked at the throng it occurred to me how differently the scene looked from when I was diagnosed with this dreaded disease in 1997. Interest in myeloma wasn’t very high then and all I could read reminded me to expect death within 3 years. It is likely that no one listening to Professor San-Miguel now has the expectation that normal risk myeloma patients they care for will die within 3 years. Consider how far we have come and how much more interest there is in myeloma now than then. That realization, along with rooms full and overflowing for every session on myeloma, was the highlight of ASH.
Professor San-Miguel was given a full hour for his presentation and it was filled with information and optimism, his title being: “Multiple Myeloma: a Model for Scientific and Clinical Progress.” He explained the incidence and pathophysiology of myeloma including the intricate interaction between malignant plasma cells and the microenvironment of bone medullary space. He gave a good review of our growing knowledge of the disease, pointing out that genomic instability is a hallmark of myeloma and that almost all patients are cytogenetically abnormal. A good part of his hour was used to explain treatment options for patients in various stages of disease for newly diagnosed, elderly and the growing numbers of those of us who have relapsed. Finally he reviewed some of the promising treatments being used in clinical trials right now as they progress toward formal approval.
In an interesting juxtaposition to all this good news about myeloma there was genuine frustration with the full rooms, full over-flow rooms, and large crowds of MDs and PhDs turned away from entering the myeloma sessions. The previous record for ASH attendance was 23,000; this year ASH President Dr. Linda Burns announced there were over 26,000. The prime oral presentations for myeloma occurred on Sunday from noon to 1:30 and the crowd size was stunning. I was one of hundreds who were disallowed to enter the main presentation room, and hurried down the hallway to the overflow room. Dozens of us pushed in and literally sat on the floor to hear Keith Stewart’s update of the ASPIRE trial of carfilzomib. As Moscone Center personnel demanded us to leave I heard one lady with a foreign accent frustratingly say, “I came here from half-way around the world to be at this session.” We left. As disappointing as this was I do see things differently as a myeloma patient and am happy at the intense interest in all things myeloma. Each bit of research contribution gets us closer to a cure.
There is tremendous interest in our disease as we get closer and closer to curative treatment. We need that interest. As much as we’ve improved our therapeutics, myeloma continues to kill us and we obviously still need more. We’re not there yet; we don’t have a cure but we WILL!