2022 Tandem Meetings | Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR
Mortimer M. Bortin Lecture
Monday, April 25, 2022 (6:45 p.m. – 7:15 p.m. MT)
- Progress in Chronic Graft-Versus-Host Disease Over the Past 2  Decades: It Took a Village
- Presented by Stephanie J. Lee, MD, MPH
Chronic graft-versus-host disease (GVHD) remains a major cause of morbidity and mortality for our hematopoietic cell transplant (HCT) survivors, despite better prophylaxis given at the time of graft infusion. Progress over the last 20 years through the work of so many people has improved our understanding of pathophysiology and expanded our treatment options. The three NIH consensus conferences created definitions for diagnosis and response assessments that form a pathway for drug approval. Three agents are now FDA-approved for treatment of chronic GVHD, and many more novel agents are being developed and tested. This progress would not have been possible without the collaboration of many communities – investigators, patients and caregivers, clinicians, patient advocacy groups, funders, pharmaceutical companies, and regulators. Yet, many patients still do not respond to treatment or they progress after an initial good response so there is still a lot of work to do. Chronic GVHD remains associated with infections, subsequent neoplasms, organ dysfunction, poor quality of life, high treatment costs and a higher risk of mortality. Imagine how much safer and successful HCT would be and how many more patients could be cured of their hematologic diseases if chronic GVHD was less of a threat. In this talk, I will provide my perspective on where we’ve been and where we can go, if we all work together.
-View Dr. Lee’s full bio here.
E. Donnall Thomas Lecture
Monday, April 25, 2022 (7:15 p.m. – 7:45 p.m. MT)
- Improving Cancer Immunotherapy: Follow Your Gut!
- Presented by Marcel R.M. van den Brink, MD PhD
The gut microbiota consists of a community of diverse microbes and has many effects on human (patho)physiology. In recent years, changes in the intestinal microbiota have been associated with many diseases, including gastrointestinal, respiratory, hepatic, autoimmune, metabolic, oncologic, neurologic, cardiovascular, and psychiatric, but causal inference is often lacking. Our preclinical and clinical studies have demonstrated that the intestinal microbiota can regulate innate and adaptive immunity, including T cell and antitumor immunity after allogeneic hematopoietic cell transplantation (allo-HCT) and chimeric antigen receptor T cell (CART) therapy. For example, we showed that microbiota composition undergoes significant and frequent changes during allo-HCT and that lower intestinal microbiota diversity is associated with increased mortality. We also found that dominance by certain species, most frequently Enterococcus, is associated with lethal graft-versus-host-disease (GVHD); that exposure to certain antibiotics is associated with worse outcomes after allo-HCT and CART therapy; and that hematopoietic reconstitution is associated with the presence of beneficial flora. These studies have been translated into clinical trials using administration of defined bacterial consortia, and antibiotic stewardship to spare and/or restore the commensal flora.
- View Dr. van den Brink's full bio here.