2020 TCT | Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR
 
 
 
Lectures
 

Mortimer M. Bortin Lecture

Friday February 21, 2020 (5:50 PM – 6:20 PM)

Mortimer M. Bortin Lecture Summary by Dr. Shinichiro Okamoto: Challenges of Hematopoietic Cell Transplantation in Asia-Pacific Countries/Regions

At present hematopoietic cell transplantation (HCT) starts moving to the age of refinement. Enlightened use of innovative targeted and immunotherapeutic agents in combination with HCT promises to reduce relapse and further improve its outcome. Contemporary immunotherapies are already being effectively administrated in conjunction with HCT to prevent life-threatening viral infections or relapse of malignant diseases. However, translation of those promising approach into first-line clinical routine is still limited by the availability of technique, limited compatibility of classical phase III designs with cellular therapy, and regulatory restrictions. Multinational efforts and global collaboration of HCT societies are definitely required to overcome the obstacles. 

In addition, the unique challenges in HCT remain in Asia-Pacific countries/regions. Although the activity of HCT in Asia-pacific countries/regions as a whole has kept growing in terms of the numbers of transplantations, about two third of Asia-Pacific countries/regions still remain in the age of exploration and expansion in HCT, where the infrastructure for supporting HCT, financial supports and regulatory policies for innovative therapies vary significantly from those in Western countries. The Asia-Pacific Transplantation Group (APBMT) was founded in 1992 and has been working for promoting the activity of HCT in Asia-Pacific countries/regions. The APBMT vision encompasses these important issues by providing emerging countries with training opportunities in HCT and ensuring the quality of HCT. APBMT will start HCT center accreditation project while harmonizing our approaches with the materials and recommendations of international accreditations. APBMT has also promoting the activity of transplant outcome registry in order to increase the opportunity of clinical studies among our regions. These are the big challenges of HCT in Asia-Pacific countries/regions, however, I believe great enthusiasm for HCT and the passion of Asian peoples have undoubtedly contribute to achieve this goal.

 
  
  

E. Donnall Thomas Lecture
Friday, February 21, 2020 (6:20 PM – 6:50 PM)
E. Donnall Thomas Lecture Summary by Dr. Effie Petersdorf: Immunogenetics of Hematopoietic Cell Transplantation
 
HLA antigens were first described over 60 years ago as the products of a system of closely linked genetic loci that are inherited in classic Mendelian fashion. The HLA system remains the most investigated region of the human genome, due to its importance in disease association. In hematopoietic cell transplantation, the HLA barrier has evolved from early concepts of compatibility between the transplant donor and recipient, to include two hallmarks of HLA genes: sequence diversity and the organization of genetic variation on haplotypes.
 
Much of our current understanding of the HLA barrier has been facilitated by continuous improvements in the technology to assay HLA genes and proteins. The availability of powerful sequencing methods has not only uncovered genetic variation within coding and non-coding regions of HLA genes but has also elucidated the organization of variants on haplotypes, particularly within intergenic regions that may harbor undetected transplantation determinants. The implications of HLA variation on their function is entering a new phase. Novel variants that affect the level of expression of HLA antigens are increasingly identified. The role of HLA expression in graft-versus-host allorecognition is coming into focus and already has immediate implications to patient care particularly in the selection of HLA-mismatched donors for transplantation. A paradigm for the future is one founded on donor-recipient compatibility and individualized for each patient’s unique “HLA-ome”. In this way, structure informs function.