Breakthroughs in acute leukemia, myeloma and systemic problems: the largest hematology conference this year in Poland is taking place in Lublin

The most outstanding Polish and international experts dealing with hematological cancers take part in the 5th international conference “Clinical and Experimental Hematology”. The topic is very important because more and more people in Poland will suffer from these cancers. Their treatment has made great progress in recent years, but there are also huge challenges due to the growing number of patients. Thanks to increasingly effective therapies, patients are living longer, but they often require long-term treatment, and new patients are emerging. This creates organizational challenges: therefore, during the conference, in addition to topics related to modern diagnostics and treatment, there are also topics related to the organization of treatment.

– We are happy that we have a huge breakthrough when it comes to the possibility of using modern treatment. In the last 5 years, we have had 75 new reimbursed molecular indications in 26 hematological, cancer and non-cancer diseases – emphasizes Prof. Ewa Lech-Marańda, national consultant in the field of hematology.

Systemic problems: will the network solve them?

– In Poland, people currently have to wait over a year to see a hematology clinic. Admission to hospital is theoretically better; National Health Fund data show that there is no waiting time for emergency admission, but in practice it often looks different. Sometimes patients, their families, or doctors from other hospitals call us, asking about the possibility of admitting the patient urgently. If these are patients with, for example, acute myeloid leukemia, they should not wait. It happens that we have to refuse because we simply have no places and patients are lying in the corridors anyway – said Prof. Grzegorz Basak, head of the Department of Hematology, Transplantology and Internal Diseases of the Medical University of Warsaw, during a session on systemic problems in patient care.

The problem is, among others, too few hematology “beds” in hospital wards, and often administrative problems: some procedures, e.g. diagnostic ones, can only be billed as part of the patient's hospitalization.

– Systemic changes are necessary, including: transfer of care for some patients to specialist clinics so that patients who should be diagnosed and treated urgently, requiring highly specialized procedures or treatment of serious side effects that may occur after the use of modern drugs, can be quickly admitted to hematology departments in hospitals – said Prof. . Krzysztof Giannopoulos.

It happens that primary care physicians unnecessarily refer patients to clinics and hospitals; but on the other hand, there are cases when diagnosis in primary care takes too long and the patient is referred to a hematologist too late. – Therefore, it is necessary to have very good cooperation between primary care physicians and hematologists, and to create appropriate systemic solutions for such cooperation – emphasized Dr. Tomasz Zieliński, vice-president of the Zielona Góra Agreement.

The challenge is staff shortages in hematology; Therefore, it is worth encouraging young doctors to choose a clinical and scientific path in this rapidly developing field. – Hematology is a field of medicine in which you can develop both scientifically and clinically, while being satisfied with your work – emphasize hematologists.

– Currently, there are approximately 600 hematologists in Poland, there should be more. The situation is improving, but there are still vacancies. A system of incentives is needed for doctors to choose this path of specialization. When it comes to the organization of treatment, a pilot project for the National Hematology Network has already been developed, I hope it will be implemented quickly – said Prof. Ewa Lech-Marańda.

Deputy Minister of Health Marek Kos, who was present during the debate, assured that work will be underway to introduce the National Hematology Network, as well as to create systemic mechanisms for better cooperation between primary care physicians and hematologists (perhaps creating another path of coordinated care in primary care).

Better and better diagnostics, new treatment methods

We are learning more and more about the biology of cancer; this is followed by the development of modern molecular diagnostics and the design of new drugs. – Without understanding the biology of cancer, effective treatment would not be possible, which is why the development of both basic and translational research is so important – emphasized the participants of the debate on research in hematology.

Thanks to modern diagnostics, it is now possible to determine what mutation led to the development of cancer in order to administer the most effective treatment and monitor its effectiveness. In recent years, access to modern molecular diagnostics in Poland has been improving, although unfortunately there are still patients for whom this diagnostics is incomplete.

New therapies provide great hope for patients, thanks to which in many cases it is possible to cure or control the disease for longer and extend life. Today, Polish patients have access to many of these modern drugs. – However, science is developing, so we will definitely have further reimbursement needs. We are still waiting for reimbursement decisions, including: regarding bispecific antibodies in the treatment of multiple myeloma and aggressive lymphomas; we are waiting for the expanded availability of CAR-T technology in acute lymphoblastic leukemias; on single drug technologies in multiple myeloma or other lymphoproliferative diseases. However, seeing how consistently the Ministry of Health has strived to make new therapies available to patients, we hope that this will continue to be the case – said Prof. Krzysztof Giannopolos.

Bispecific antibodies and CAR-T technologies are the two fastest-growing groups of drugs in hemato-oncology today. Some are already available to patients in Poland, others are in the reimbursement process, and in the case of some companies have not yet submitted applications for reimbursement. During the conference panels, hematologists also discussed, among others: about the sequence of treatment used (e.g. CAR-T first or bispecific antibodies).

Polish hematology at European level

Polish hematologists participate in international research and expert groups: the development of hematology is not possible today without international cooperation. The conference is attended by outstanding experts from both Poland and abroad. The opening lecture on the diagnosis and treatment of acute myeloid leukemia was delivered by prof. Konstanze Döhner from the University Hospital Ulm, president-elect of the European Society of Hematology (EHA) and chairwoman of the German-Austrian AML Study Group (AMLSG), one of the world's leading research groups on this topic .

Safety of treatment with blood components

An important element of hematological treatment is the transfusion of blood components: this year, for the first time, transfusion sessions are part of the conference. – Transfusionology is an indispensable element of proper treatment, especially for oncohematological patients who may require a large number of transfusions of various blood components, sometimes in a short time. Clinical effectiveness is important, but above all the safety of blood components to minimize the risk of post-transfusion reactions – said Prof. Jolanta Antoniewicz-Papis from the Institute of Hematology and Transfusionology in Warsaw, coordinator of transfusion sessions of the 5th International Conference “Clinical and Experimental Hematology”.

In Poland, treatment with blood and its components is very well organized; New diagnostic methods for serological and virological tests are being implemented, and for many years no transmission of any tested virus with blood components has been detected. However, despite careful selection of donors and checking the blood for the presence of markers of HBV, HCV and HIV viruses as well as syphilis infection, there are ongoing discussions in the world, as well as in Poland, about additional tests for the presence of other pathogens, including: hepatitis E virus (HEV), as well as new methods of virus inactivation. However, the most common cause of adverse reactions after transfusion is human errors. – It's like that all over the world. Therefore, we emphasize that at each stage of blood treatment it is very important to follow strictly defined procedures, regulations and guidelines. Any deviations may pose a threat to the donor or the patient – noted Prof. Antoniewicz-Papis.