Newsletter November 2008

newsletter the official newsletter for members of the EHA

November 2008

EHA New Newsletter MayStates 2007 Jersey, United by > Marc2Rudoltz

President’s Message: Education in hematology: the annual congress and more In this issue we look back at the 13th Congress in Copenhagen. We are happy to announce that the congress yielded a record number of participants, over 6,600, and its program was of highest scientific and educational quality. This success is largely due to the efforts of the Scientific Program Committee (SPC) and its Advisory Board (SPC AB), which I would like to thank for fulfilling their tasks so proficiently. Also, I would like to thank the sponsors for their contribution to make the congress possible. I believe that a creative collaboration with pharmaceutical partners is essential for positive developments in any field of medicine.

>  We also look forward. The preparations for the 14th Congress in Berlin are in full swing. To enlighten you on how the educational and scientific program of the annual congress is put together, Radek Skoda has written a very informative article about the SPC and the SPC AB. The annual congress of EHA is one, albeit important, instrument to promote education and lifelong learning in hematology. For instance, EHA would like to reach out to those who are unable to come to the annual congress. Also, despite our efforts to arrive at a comprehensive and well balanced educational program at the annual congress, not all topics in the field of hematology can be covered. Here, I would like to focus on those instruments that may be a little less known to you. To achieve greater outreach and to cover niche topics EHA organizes two-day tutorials and workshops, it webcasts its annual congress’ educational sessions,

2 > EHA Newsletter November 2008

and has developed training online (EHATol). What EHATol exactly is, is explained in this issue by Gina Zini, who, together with the EHA executive office, shows great dedication in making available five self-evaluation tests every three months. I kindly invite you to take these tests yourself. Furthermore, plans are under way to have the webcasts themselves CME accredited and to extend the webcasts to the workshops. In the end, the goal is to combine these learning tools into a blended learning experience. Another aspect of education concerns not so much how we learn, but what we learn. Recently, the European Commission has awarded a network of European national societies of hematology, the European School of Haematology (ESH), the Universities of Uppsala and Liverpool, and EHA a grant of up to € 600,000. The network’s name is H-Net and it aims to further develop the European Hematology Curriculum by identifying and measuring gaps in hematological knowledge

Willem Fibbe

and skills across Europe. The results will serve to target the gaps with existing and novel educational tools. In addition, HNet will develop an online portfolio system which identifies educational needs of individual hematologists and offers suggestions to meet them. In coordinating H-Net, EHA reinforces its dedication to arrive at a truly harmonized curriculum for European hematologists, raising competence levels and, ultimately, improving patient care and public health. I encourage you to read Eva HellströmLindberg’s contribution to this issue which describes the grant application process and the details of the H-Net’s ambitions. Willem Fibbe EHA President

The makings of the European hematologist: H-Net “Yes, we can!” Echoing Barack Obama’s primary campaign slogan, Nancy Hamilton and Thom Duyvené de Wit of the EHA Executive Office responded to my question. It was over lunch at the January 23, 2008 board meeting in Amsterdam that I asked if the EHA Executive Office has the capacity to make a European Commission application for a grant to promote the implementation of the Curriculum Passport. The deadline for submission was, however, February 29, 2008.

>  In 2005 the national societies of hematology in Europe, the European School of Haematology (ESH) and EHA jointly developed the European Hematology Curriculum. The Passport is a booklet designed for hematologists in training to check off subjects within the specialty, and the level mastered (ranging from awareness to competence). The trainee’s mentor confirms completion of each subject with a signature. The Curriculum Passport aims to promote the harmonization of qualifications and the mobility of hematologists throughout Europe. Harmonization was achieved after the national societies of hematology, ESH, and EHA, agreed on what constitutes a hematologist. The Curriculum Passport also promotes mobility, since different mentors can take

responsibility for different sections, allowing trainees to receive part of their education in one country, and part somewhere else. To cut a long story short, the strenuous efforts (and nocturnal working practices) of D Jasmin of ESH, of C Hok-Toh, P Rebulla, A Urbano, and L Degos of the EHA curriculum committee, and of C Smand and the others of the EHA Executive Office made the impossible possible. Finally, a night taxi ride to the headquarters of DHL near Amsterdam airport secured the all important date-stamp - February 29, 2008. The application we sent that night was named ‘European Network for Harmonisation of Training in Haematology’; HNet. It was sent in response to a call for

proposals issued by the directorate general Training and Education of the European Commission. We applied for a Leonardo da Vinci network grant in the Lifelong Learning Program. The aim of H-Net is to further implement a harmonized curriculum for Hematology in Europe. The core of the project consists of two phases. First, a survey will be undertaken of recently graduated hematologists to assess their qualifications, then the results will be compared to the recommendations expressed in the Curriculum Passport. The survey should allow H-Net to identify gaps in hematology training throughout Europe. For instance, we may observe that in country A, respondents score below the recommendations with respect to their knowledge and competence in the area of bone marrow failure while in country B respondents consistently achieve low scores in the diagnosis of immunophenotyping by flow cytometry. Such information, summarized in a “European expression map for competence in hematology”, would enable informed decision making. National societies, national authorities, and individuals themselves, can decide on targeted additional education. Conversely taking into account their national context, countries may decide against addressing situations they feel are not

Contents President’s Message

2

SPC and SPC AB

11

H-Net

3

13th Congress

12

Translational research

4

Collaboration ESH-EHA

15

EHATol

5

Letter to the Editor

16

Editorial: Collaboration with pharma

6

Overview EHA Committees an Units

17

Scientific Working Groups

7

Current members of the EHA Board of Directors

18

Young investigator award

9

Upcoming congresses

18

EHA Executive Office

19

Wine and health

12

EHA Newsletter November 2008 > 3

relevant to their population. In Nordic countries, for example, awareness rather than competence may be considered adequate for thalassemia major. In essence, H-Net survey results would enable decision making to be based on fact rather than assumption, and allow comparisons to be made against European benchmarks. In the second phase H-Net will use the information to tailor existing educational tools, such as workshops, tutorials, and webcasts. The results will also be used to develop a new educational instrument called the Hematology Master-Class, to fit the educational needs of hematologists and organize them in the countries where they are most needed. Furthermore, as part of H-Net individual hematologists will be able to create online personal profiles, known as the Hematology Portfolio, not unlike those of network websites, such as LinkedIn, MySpace, or FaceBook. In the portfolio applications, which are being developed by the University of Uppsala Learning Lab, one of the partners of H-Net, hematologists can enter their

own qualifications which will be compared to the recommendations of the Curriculum Passport allowing personal gaps to be identified. The Hematology Portfolio will then automatically make training suggestions specific to the individual educational needs of the hematologist, which may be workshops, tutorials, training opportunities organized by third parties, or recommendations from other portfolio holders. Ultimately, the portfolio system should become a widely used professional network of hematologists throughout Europe. With the European Commission aiming to promote mobilization of health professionals and improve competence across the board, the H-Net project undoubtedly has implications that go beyond hematology. Currently health education organization and content remain a national prerogative, with the European Commission having no jurisdiction. The Commission realizes that harmonization of qualifications will only take place if European professionals themselves convince their national authorities of the need for educational reform. H-Net plans to meet this challenge by organizing two policy

conferences to bring together the national authorities and the European Commission to discuss the road map towards a harmonized curriculum for hematology and, possibly, other medical specialties. Friday June 13 - the second day of the 13th EHA Congress in Copenhagen turned out to be our lucky day. The European Commission couldn’t have chosen a better moment to inform us that our application had passed the evaluation: most of the people who worked on the project were there, so we managed a celebration drink, or two. Now, the hard work starts in earnest, and all involved are very excited because H-Net provides us with the opportunity to work together again on an interesting and important project. I hope, having read this article that you will agree. Eva Hellström-Lindberg, EHA Past President and Chair of the EHA Curriculum Committee Karolinska University Hospital, Stockholm, Sweden

Translational research boost for Europe A scheme to create a new training program in translational research, encompassing both malignant and non-malignant hematology is currently being planned in a joint initiative between the EHA and American Society of Hematology (ASH). The Translational Research Training in Hematology (TRTH) program is intended to boost standards of translational research in Europe, an area that has been identified as under resourced.

>  The TRTH program, first proposed at the 2006 ASH-EHA leadership meeting, in Orlando, Florida, is currently being planned along similar lines to the ASH Clinical Research Training Institute, a program that focuses on Phase I and II clinical trials. The proposed format of the TRTH program, which is being targeted at clinicians, translational scientists and bio4 > EHA Newsletter November 2008

medical students, is for participants to attend a six day residential course. Subjects likely to be covered in the ‘bench to bedside’ course include, diagnostics, bio banking, bio statistics, bio informatics, candidate gene testing and stem cell research. In addition, EU legislation, rules, directives and guidelines related to good clinical practice will be discussed, and sessions covering issues relevant to grant applica-

tions and scientific paper writing will be planned. Participants will bring their own translational research proposals as part of the application process for the TRTH program. These proposals will be discussed in interactive sessions, with the goal of improving the quality of grant submissions. Opportunities for “sustained mentoring” will be offered at follow up sessions scheduled to coincide with the EHA and ASH annual meetings. Issues that still remain to be resolved include eligibility for participation and review of the applications. Another important open item is funding of the scheme. We will keep you posted as this exciting initiative unfolds. Ivo Touw, Co-Chair TRTH Subcommittee Erasmus Medical Center, Rotterdam, The Netherlands

EHATol distance learning tool gains popularity >  In 2006 EHA launched an innovative new project, EHA Training Online (EHATol) for scientists and clinicians involved in the field of hematology. EHATol is an online distance learning tool, providing a readily accessible and constantly updated content for training, education, and CME, with clinical cases presented and the opportunity for on-line self assessment. What is a Clinical Case? Each clinical case, consisting of 14-19 chapters begins with the disease history, followed by descriptions of clinical examinations, blood tests, cytogenetics and other diagnostic studies. The diagnosis and treatment recommendations are then described. According to the latest statistics, each clinical case was visited by an average of 143 users.

What is a CME Test Case? There are three parts to a CME Test Case -the introduction- (history of the disease), questions and results. Each self-evaluation test comprises six multiple choice questions, with users allowed three attempts to respond correctly to all six questions in order to earn one CME credit point. In August 2008 we extended the number of self assessment tests available, with each set now including five cases. The result is that users of the EHATol platform may now earn up to 20 CME credit Figure 1

The EHATol unit met in Copenhagen

points per year by correctly completing the self-evaluation tests.

Join now!

EHATol is becoming increasingly popular, with more than 4000 users from 60 different countries having already updated their knowledge using the EHATol platform.

Every three month a new set of the self assessment cases will become available online. EHATol is free of charge and available on the EHA website. If you would like to get access to clinical and CME Test cases please register via www.ehatol.org.

The number of visitors in the first three quarters of 2008 increased by more then 30 per cent compared to the same period in 2007 (see figure 2).

Prof. Gina Zini, MD Chair of the EHATol Unit Catholic University of Sacred Heart, Rome, Italy

In addition, the average length of sessions and the number of connections made each day, increased significantly. Figure 2: number of visitors of EHATol

EHA Newsletter November 2008 > 5

Collaborations with the pharmaceutical industry ‘The proper basis for a marriage is mutual misunderstanding!’ Oscar Wilde. >  There has always been a symbiosis between the pharmaceutical industry and the medical profession. Although certainly not a marriage, the relationship possesses similar qualities, despite the fact that neither party can ever truly divorce! The protagonists come from different backgrounds but share similar desires. The loyalty of the pharmaceutical companies is to satisfy their shareholders, while the primary role of physicians is to provide the best medical care for their patients. Pharmaceutical companies are, of course, in the business of manufacturing drugs which benefit patients, and physicians depend on the industry to develop new and effective compounds. Dr M Greaves, from the University of Aberdeen, addressed both the possible tensions and opportunities for collaboration at the EHA annual meeting in June 2008. He began by quoting David Blumenthal’s statement from the New England Journal of Medicine: ‘when a great profession and the forces of capitalism interact, drama is the likely result’. He pointed out that research and development is declining in the industry due to a combination of patent expiration and generic competition, together with the huge costs involved in bringing new drugs to the market. It is predicted that between 2007 and 2012, $ 67 billion will be lost from the top pharmaceutical companies in the USA. Greaves pointed out that 'conflicts of interest' occur when individuals have material gains, irrespective of financial value, that could influence or be perceived as influencing their opinions, decisions or actions in relation to patient care or the conduct of research. Potential conflicts have happened to all of us in the form of hospitality, attendance at conferences, and gifts, although we always claim that our judgement is not affected. A more difficult situation arises with clinical trials, especially in Europe. Because of difficulties with cost and indemnity, the number of ‘investigator-led trials’ has decreased and the number of industry sponsored trials increased. Coupled with this is the payment for enrolling patients in industry-led trials. It must be remembered, however, that Health Services do NOT provide much support for conferences and even light lunches at clinical meetings are provided by industry in many hospitals. The industry invests large amounts of money supporting education, bringing new treatments to the attention of doctors and supporting biomedical research. Educational support is commonly in the form of an unrestricted grant but industry sponsored clinical trials are more likely to be associated with positive outcomes than investigator–led trials. Hopefully, a change in legislation in Europe will make investigator–led trials easier to conduct without endangering the public. Although we must work together, it behoves the medical profession to be advocates for their patients. The regulatory bodies are constantly criticised, not always justifiably. If they are too cautious the public becomes upset by delays in introducing new agents, which may 6 > EHA Newsletter November 2008

be beneficial, and if the regulator releases new drugs without adequate testing they are admonished for not protecting patients! Drug costs are now a huge issue for society, especially when linked to efficacy. It is quite amazing when a number of drugs with similar modes of action, but different development histories, are similarly priced without any regard to their research and development costs! Tyrosine Kinase inhibitors (TKI’s) are examples of drugs which have totally changed the outlook for patients with Chronic Myeloid Leukemia (CML). However this disease has been transformed into a chronic illness and thus patient numbers are accumulating. It is estimated that in the USA there soon will be 250,000 patients alive with CML, representing an annual cost somewhere in the region of € 7,5 billion for TKI’s. While the FDA does not take cost into account, countries – for example the UK - restrict new agents on the basis of cost-effectiveness, often resulting in a public outcry! With other expensive drugs, efficacy is difficult to demonstrate. The FDA approved a cholesterol-lowering agent in 2002 after a small number of clinical trials, which included 3,900 patients! In the absence of proven efficacy against heart attacks the drug earned billions of dollars for the company, presumably due to the robust advertising campaign. We would all agree (as mentioned in a previous newsletter) that all clinical trials should be registered and the results, whether favourable or not, be made available to the public. Finally I am always intrigued by serendipity, especially in medicine. Although we live in an age of ‘certainty’ and people speak about focused research, it remains that many great medical developments still happen by chance and hopefully will continue to do so in the future. Shaun Mc Cann Editor in Chief

Spotlight on Scientific Working Groups In 2008, EuroFlow was launched as the latest addition to the EHA Scientific Working Groups (SWG’s), bringing the total number of groups to eleven. The main objectives of the EHA Scientific Working Groups are to create scientific networks that both promote high quality science during the annual congress and attract basic scientists to meetings. To complete the picture of SWG’s - some of whom featured in earlier issues of the Newsletter - we high-light the recent activities of five of the groups.

Scientific Working Group on Granulocyte and Monocyte Disorders >  The EHA SWG on granulocyte and monocyte disorders was established in 2005 during the 10th EHA Congress in Stockholm, Sweden. The main goal is to promote co-operation between clinicians and scientists involved in basic, translational and clinical research in the field of granulocyte and monocyte disorders. Under this remit, scientific sessions during the 13th EHA Congress, covered topics on clinical and molecular diagnosis of neutropenias and unknown aspects of the role of neutrophils in innate immunity, stimulating interesting discussions in the audience that included for the first time clinicians, basic scientists and trainees in hematology. In addition, a major highlight for the year was the 3rd Neutropenia Network Conference, that took place in Crete, Greece, September 26-27, 2008, under the auspices of EHA and covered acquired and congenital neutropenias in a clinical, laboratory, cellular, and molecular biology settings.

fining various B-cell compartments that may carry early clonal characteristics. Surinder Sahota (Southampton, UK) described molecular approaches to track the myeloma compartment and identify distinct profiles for pre-plasma cells that may belong to the myeloma clone. Pieter Sonneveld presented gene expression data of myeloma patients, introducing the concept of undertaking molecular profiles of chemo resistance in myeloma stem cells. Finally, Karin Vanderkerken (Brussels, Belgium) presented data of the 5TMM myeloma mouse model, which serves as a pre-clinical model for myeloma (stem-) cell analysis. Pieter Sonneveld, Chair Erasmus Medical Center, Rotterdam, The Netherlands

Scientific Working Group: The European Study Group on MRDDetection in ALL (ESG MRD-ALL) >  Originating from a group of 15

group and the BIOMED-2 Concerted Action group, the European Study Group on MRD-detection in ALL (ESG MRDALL) has provided a framework for standardizing, improving and comparing molecular MRD-diagnostics using Ig/ TCR-gene rearrangements as RQ-PCR targets. Through 13 quality control ‘rounds’ with subsequent problem resolution meetings, common guidelines have been developed regarding both technical aspects and issues regarding interpretation of data (see: Van der Velden et al., Leukemia 2007;21:604611). At the same time, the group has grown, now representing nearly 40 laboratories from Europe, Asia and Australia, with its remit extended to cover MRD-diagnostics in malignant lymphoma. The ESG MRD-ALL SWG, provides a framework for clinical study groups who want to use MRD diagnostics within their treatment protocols. Thorsten Raff, Chair University Hospital Schleswig Holstein, Kiel, Germany

MRD-laboratories from the I-BFM study Helen Papadaki, Chair University Hospital of Heraklion, Heraklion Crete, Greece

Scientific Working Group on Multiple Myeloma >  At the 13th Congress of the European Hematology Association, the SWG on Multiple Myeloma hosted a scientific meeting, “The Myeloma Stem Cell” chaired by Pieter Sonneveld (Rotterdam, the Netherlands) and Hans E Johnsen (Aalborg, Denmark). First, Hans E Johnsen introduced the concept and scientific background of the myeloma stem cell, while Martin Perez Andres (Salamanca, Spain) addressed the B- cell hierarchy in B-cell malignancies and myeloma, de-

The current EHA Scientific Working Groups are: Scientific Working Group 1: Scientific Working Group 2: Scientific Working Group 3: Scientific Working Group 4: Scientific Working Group 5: Scientific Working Group 6: Scientific Working Group 7: Scientific Working Group 8: Scientific Working Group 9:

Chronic Myeloid Leukemia Granulocyte and Monocyte disorders Multiple Myeloma Myelodysplastic Syndromes Myeproliferative Disorders Quality of Life and Symptoms Thrombocytopenias ESG-MRD-ALL Pharmacokinetics, pharmacogenetics & pharmacodynamics Scientific Working Group 10: Red Cell and Iron Scientific Working Group 11: EuroFlow To find out more about the Scientific Working Groups, check our website at: www.ehaweb.org

EHA Newsletter November 2008 > 7

SWG chairs meeting: T Raff, C Camaschella, M Hasan, U Jäger, H Pahl and J van Dongen

Scientific Working Group on Pharmacokinetic, Pharmacodynamic and Pharmacogenetic >  Chemotherapy – despite intensive research to find more specific treatment to target tumour cells - remains the corner stone of the majority of hematological protocols. Most treatment protocols today are empirical and based on clinical experience. Despite long clinical use, little information is available about the mechanisms of action, individualization of those factors affecting therapeutic efficacy and last but not least, interactions with other drugs. The Pharmacokinetic, Pharmacodynamic and Pharmacogenetic SWG aims to improve understanding of the mechanisms of action of cytostatic drugs, to establish data-bases for EHA members, to organize and design randomized PK/PD multi-centre studies, to provide help in designing and coordinating studies and to introduce therapeutic drug monitoring and dose adjustment to optimize individual chemotherapy treatment. The hope is that implementation of PK/PD/PG knowledge of cytostatics will ultimately improve treatment strategies and patient outcomes. Moustapha Hassan, Chair Karolinska University Hospital, Stockholm, Sweden

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Scientific Working Group EuroFlow: Flow cytometry for fast and sensitive diagnosis and follow-up of haematological malignancies >  Laboratory diagnostics of hematological malignancies has three major applications: establishing diagnosis, prognostic classification, and evaluation of treatment effectiveness. While molecular techniques have brought new insights into classification and monitoring of treatment effectiveness, they are frequently time consuming (taking two to three days), not applicable for all patients, and unable to focus on cellular subpopulations without prior purification. Flow cytometric immunophenotyping is the sole technique fulfilling requirements of high speed, broad applicability at diagnosis and during follow-up, and accurate focusing on malignant cell populations using membranebound and intracellular proteins as targets. Innovations are needed in flow cytometry, such as development of novel antibodies, novel immunobead technology, eight-color immunostaining protocols, and novel flow cytometry software for fast and easy interpretation of complex data and for automated pattern recognition, all of which are key objectives for the EuroFlow consortium (EU-FP6 project LSHBCT-2006-018708). This needs a multidisciplinary translational research approach using cutting edge technologies and biological data arising from genomic research, which can be addressed best via

close collaboration between industry and academia. The EuroFlow consortium consists of two SME’s and ten diagnostic research groups, composed of experts in the fields of flow cytometric and molecular diagnostics. The EuroFlow Consortium is developing new software for fast and easy handling of large data sets and for integration of eight -color stainings into a single multicolor data file; standardization of eight -color immunostaining protocols for fast and easy flow cytometric diagnosis and classification of hematological malignancies (as well as evaluation of treatment effectiveness); multiplex immunobead assays for detection of fusion proteins and oncoproteins per disease category (particularly ALL and AML); and software for automated pattern recognition of normal, reactive, and aberrant (malignant) leukocyte populations in blood and bone marrow. In addition, we are looking to create large data bases with 100s of well-defined normal, reactive and malignant cell samples, which can be used as ‘templates’ for fully automated comparisons with patient samples. As soon as the projects have been completed and approved, the results will be shared at Scientific Working Group sessions of the annual EHA meetings. J van Dongen, Chair University Medical Center, Rotterdam, The Netherlands

Young investigator award to study CDX2 in AML Stefan Fröhling: Winner of the EHA José Carreras Foundation Young Investigator Fellowship 2008 >  It is a great honor for me to be the recipient of this year’s EHA José Carreras Foundation Young Investigator Fellowship, particularly given the high standard of previous beneficiaries as well as the high quality of the applications considered this year.

knowledge about the normal functions of CDX2, other gene products that mediate the leukemogenic effects of CDX2, including potentially therapeutic molecules, are not known.

A particularly enticing aspect of these observations is that aberrant expression of CDX2 appears to affect the majority of I first learned about the EHA Fellowship AML patients. Thus, understanding Program in 2002 when I attended the 7th mechanisms of transformation mediated Congress of EHA in Florence. Since that W Fibbe presents Stefan Fröhling with the award by CDX2 are likely to be of value for the time, I have been appreciative of the efforts made by the EHA in promoting the career development of broad spectrum of AML, and not solely for selected genetic or morphologic subtypes. Furthermore, although it is challenging young scientists involved in hematologic research. to target transcription factors therapeutically, evolving techMy application for an EHA Fellowship was motivated by a com- nologies may enable novel approaches for treatment. For exbination of factors. First, based on the excellent track record of ample, large-scale RNA interference (RNAi) screens for synpast recipients, I realized that an EHA Fellowship provides a thetic lethal interactions, and unbiased small-molecule superb platform for young investigators to pursue a career in screens have potential to identify compounds or pathways that academic hematology. Second, I was encouraged to apply for will effectively target CDX2 overexpression in AML. an EHA Fellowship by my academic mentors, Prof Hartmut Döhner from my home institution (University Hospital of Ulm, The goals of my project are to characterize the transcriptional Germany) and Dr Gary Gilliland (Harvard Medical School, Bos- changes induced by ectopic expression of CDX2 in hematopoiton, USA), my current supervisor. Lastly, during my postdoc- etic stem and progenitor cells in vitro. Another goal is to detertoral fellowship, I had the privilege of working with Dr Brian mine the gene-expression profiles of murine leukemias inHuntly (Cambridge Institute for Medical Research, UK), who duced by ectopic expression of CDX2 in hematopoietic stem had received the EHA José Carreras Foundation Young Investi- and progenitor cells in vivo. Furthermore to determine the gator Fellowship in 2005. During my time with Brian, I learned transcriptional changes associated with genetic inhibition of about the many advantages of an EHA Fellowship, both the fi- CDX2 in human AML cell lines and to identify candidate downnancial support, as well as the opportunity to become part of stream effectors of aberrant CDX2 expression in myeloid leuthe European hematology community. kemogenesis through bioinformatic analyses, cross-species comparisons, and integration of the results from experimental My EHA José Carreras Foundation Young Investigator Fellow- models of hematopoietic transformation with gene-expression ship will be used to study the role of the homeobox transcrip- profiles and clinical data from patients with AML. Lastly we tion factor CDX2 in the pathogenesis of acute myeloid leukemia want to experimentally validate candidate downstream effec(AML). In a collaborative project between my home institution tors of aberrant CDX2 expression in myeloid leukemogenesis. and the Gilliland Laboratory at Harvard University, it was previ- Longer-term ambitions include a genome-wide RNAi-based ously discovered that the CDX2 gene was expressed in the leu- functional genetic strategy to identify genes that are essential kemic cells from the majority of adult patients with AML, for the viability and proliferation of leukemic cells specifically whereas CDX2 expression was undetectable in the normal in the context of aberrant CDX2 expression. adult hematopoietic compartment. Furthermore, we and others have demonstrated the functional relevance of aberrant The generous funding provided by the EHA José Carreras CDX2 expression in a series of in vitro and in vivo experiments. Foundation Young Investigator Fellowship is of critical imporFor instance, CDX2 enhanced the capacity of myeloid progeni- tance for the realization of these goals. More broadly, I believe tor cells to self-renew, an important functional attribute of that initiatives like the EHA Fellowship Program will encourage most, if not all, AML subtypes, suggesting that CDX2 may be a young investigators, especially those who are trained as physicommon downstream effector of different leukemogenic path- cians, to commit themselves to a career in hematologic reways. Expression of CDX2 led to dysregulation of Hox genes, search. known transcriptional targets of CDX family members during development, supporting a potential role of CDX2 in the devel- Stefan Fröhling opment of human AML with aberrant HOX gene expression. Winner of the EHA José Carreras Foundation Young Investigator Since the consequences of aberrant CDX2 expression have not Fellowship 2008 been studied using unbiased approaches that require no prior University Hospital of Ulm, Germany EHA Newsletter November 2008 > 9

Wine and health: End of Road for French Paradox? Giovanni Morelli, EHA's resident wine authority, updates us on the resveretrol heart health story, and delivers a mixed bag of news for wine lovers. A decline in wine consumption in France and craving for fast food is being balanced by EU initiatives to expand production of quality wine.

>  The wine industry extols the merits of drinking wine, and we all marvel at the proposed health benefits. We mentioned the possible benefits of resveretrol in previous newsletters but decided that the amount of wine required daily to provide a protective effect would probably induce severe liver damage, thereby negating any putative benefit. However things might be getting better! In a study, published by Richard Weindruch and colleagues, from the University of Wisconsin-Madison, (PloS ONE 2008:3: e2264) they claimed that mice given low dose resveretrol were protected from heart disease. They report that low dose resveretrol inhibits gene expression profiles associated with cardiac and skeletal muscle aging, and prevents age-related cardiac dysfunction. Dietary resveretrol also mimics the effects of calorie restriction in insulin mediated glucose uptake in muscle. Gene expression profiling suggests that resveretrol may retard some aspects of aging through alterations in chromatin structure and transcription. Resveretrol, at doses that can be readily achieved in humans (three to

All grapes are green in the beginning

10 > EHA Newsletter November 2008

four glasses of red wine daily), fulfills the definition of a dietary compound that mimics some aspects of calorie restriction. Some may feel three to four glasses of wine daily to be excessive and that perhaps one or two glasses of wine supplemented with oral resveretrol would do the trick. A lot of this type of research is based on the so-called 'French paradox'. However the bad news is that the French are reducing their intake of red wine and taking to fast-food. Yes, less than 50 percent of young people in France are drinking wine and only 10 percent consume it regularly! In 1980 the average consumption of wine in France was 120 liters per year and this has fallen by 50 percent. Paradoxically wine drinking in America in the 21 – 29 year age group is the most rapidly growing segment of the world market. What is more worrying is the loss of eating habits and the craving for fast foods. The number of family meals and business lunches has decreased by 50 percent in the last 10 years in France and obesity is on the increase. Diana Macle writing in the Wine Spectator quotes Professor Francois d’Hauteville as saying: ‘The young people I interviewed recognized that wine was part of French culture and identity but they know very little about it, and many didn’t even like the taste!' Perhaps the French Paradox will become a thing of the past. Another interesting use of resveretrol is in the treatment of MELAS. This syndrome, characterized by mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes, is caused by mitochondrial dysfunction and is currently undergoing a randomized trial using resveretrol (STR501) as a mitochondrial stimulant! As physicians we all have become aware of a number of drug scandals recently,

Wine tasting can be fun unless taken too seriously!

but the wine business is not immune from controversy. In Montalcino, that most beautiful of hill towns in Tuscany, their high priced Brunellos have come under scrutiny. The public prosecutor in Siena, Nino Calabrese, is investigating famous names including Frescobaldi and Banfi for possibly using grapes other than Sangiovese or importing grapes from other areas. In the US billionaire wine collector, William Koch - no relation as far as I am aware to Robert Koch who in 1890 established the etiology of Anthrax and Tuberculosis - found that wines that he had bought were not in fact part of Thomas Jefferson’s collection as he had been led to believe! He paid a large amount of money for his mistake! There is a huge surplus of wine (mostly poor quality) in Europe today, illustrated by the fact that in 2006 the EU spent € 2 billion distilling surplus wine into industrial alcohol! Marianne Fischer Boel, EU agriculture commissioner, is trying to help by convincing small growers to retire and pull out 400,000 acres of vines and subsequently to phase out distillation subsidies. Michael Mann, spokesman for the EU agriculture and rural development department, is quoted as saying: ‘In the short term production will decrease but when planting restrictions go, there is no reason why production of quality wine should not expand’. For both our heart health and drinking pleasure, let us hope that both Weindruch and Mann prove correct. Giovanni Morelli Giovanni Morelli is a hematologist who divides his time between Dublin and Tuscany

The Scientific Program Committee (SPC) and SPC Advisory Board (SPC AB): how does it work? Preparations for the 14th EHA congress, to be held in Berlin, Germany (June 4-7, 2009) are now full steam ahead. For every congress, the EHA Board appoints a Scientific Program Committee (SPC), whose role is to compose a program for the annual congress that meets the highest scientific and educational standards. The SPC is supported by members of the EHA Executive Office under the lead of Rik Craenmehr, who serves as the Congress Assistant, with the remit of assuring an efficient and reliable organization.

ment of educational activities outside the annual congress. Finally, one member of the SPC is responsible for maintaining the database of abstract reviewers. This database is checked annually for accuracy, areas of expertise and balance with respect to gender and nationality of reviewers.

How do SPC and SPC AB work? The SPC will receive support from the SPC-AB, which submits suggestions for the invited speakers program and contributes to selecting the abstracts for presentation at the congress. The SPC-AB consists of 20-25 members, who serve for 1-2 years and are eligible to serve on the SPC. Every year, about 12 members rotate off the SPC-AB and 12 new members are appointed. The SPC-AB should be balanced for the different areas of expertise, stages of career, gender, and nationality. The EHA Board approves and appoints the SPC-AB, after receiving suggestions by the SPC chair.

Radek Skoda

>  SPC member by appointment First some background information. The SPC consists of 10 full members who are appointed by the EHA-Board. The Congress President serves as the 11th member of the SPC for one year. All other SPC members serve for two years, except for the SPC chair, who serves for three years. The chair of the SPC is appointed by the Executive Board as chair of both the SPC and the SPC Advisory Board (SPC-AB). The SPC is responsible for the important task of putting together the scientific and education program for the entire EHA Congress. Every year one former chair and 3-4 full members rotate off the SPC and are replaced by the EHA-Board. The 10 full members of the SPC should cover the entire field of hematology. A minimum of two full members of the SPC should also be members of the EHA Board and at least one full member of the SPC is also member of the EHA Education Committee to ensure coordination between the activities of the two committees. The EHA Education Committee is primarily involved in the develop-

The Scientific Program Committee and the Advisory Board have two principal tasks. One is to choose the invited speakers and their topics. Both members of SPC and SPC AB are expected to submit proposals. The proposals are collected in August and discussed during the meeting of the SPC in September. A selection of topics and speakers is made during this meeting and the program is prepared and finalized during the last months of the year. The second task of the SPC and SPC-AB members is to review submitted abstracts and to select abstracts for poster or oral presentation. This takes place during a meeting in the first week of April 2009. I would like to encourage you and your colleagues to submit abstracts for EHA-14. Please remember that there are up to 80 travel grants that are assigned in the order of the ranking that an abstract receives. In previous years all abstracts selected for oral presentation and a substantial number of posters received a travel grant. The deadline for abstract submission is March 1, 2009. I look forward to seeing you in Berlin! Radek Skoda, SPC Chair for EHA-14 University Hospital Basel, Switzerland

EHA Newsletter November 2008 > 11

Copenhagen hosts 13th EHA Congress 10 countries: Top Top 10 countries: registrationsregistrations

The 13th Congress of the European Hematology

2008:

2007:

Italy

680

474

•

United Kingdom

453

349

•

France

455

390

•

Greece

383

317

•

Spain

364

300

•

United States of America

337

214

•

Germany

329

277

•

Switzerland

216

214

•

The Netherlands

213

180

•

Denmark

181

88

Association (EHA) in Copenhagen (June 12-15, 2008)

•

will be remembered as yet another successful event in the annals of EHA congress. The meeting attracted over 6600 delegates from 103 countries, who enjoyed a wide ranging scientific program of the highest quality.

WWW.EHAWEB.ORG

>  Altogether nearly 1800 abstracts were submitted. During the Presidential Symposium the five best abstracts were presented and 80 oral presenters were awarded with travel grants of € 500 and free congress registration. Once again, the redcapped EHA ‘poster walkers’ proved a popular draw, encouraging lively discussions among interested delegates. Two outstanding hematologists were honored in Copenhagen. The EHA José Carreras Award was made to Professor John Goldman (Imperial College London, United Kingdom), while Professor Dieter Hoelzer (University Frankfurt, Germany) received the EHA Jean Bernard Lifetime Achievement Award. EHA-CME desks

Professor Goldman has played an important role in one of the major success stories of leukemia therapy, with his work contributing to the fact that chronic myeloid leukemia (CML) patients can now hope to live normal life spans. Professor Goldman was a pioneer in the use of bone marrow transplants in CML, a therapy that became the standard of care for two decades. In the late 1990s, when new drugs were developed to block the effects of the genetic changes causing CML, Professor Goldman led the efforts to develop new technologies to detect residual levels of CML. Professor Hoelzer, head of the Institute for Hematology at the University of Frankfurt am Main, has contributed to many of the recent advances in treatment of adult acute lymphoblastic leukemia (ALL). Bella Center in Copenhagen, Denmark

Registrations 1994-2008 6672

7000 7000 6000 6000

He set up a cross-German study group involving more than 100 hospitals to examine therapies and their effectiveness in treatment of ALL, at a time when the disease had a cure rate of less than 10 percent. The study group contributed to substantial

Registrations per continent Registrations per continent

5000 5000

81%

4000 4000

Europe Asia

3000 3000

North America

2000 2000

South America Australia

1000 1000 00

1s 1s tt

2nd 6th 2nd 3rd3rd 4th 4th5th 5th

7th 6th

8th 7th

9th8th 10th 9th11th 10th 12th 11th 13th

WWW.EHAWEB.ORG 12 > EHA Newsletter November 2008

3% 1% 3%

5%

7%

Africa

Abstracts 1996-2008 1892

2000 1800 1600 1400 1200 1000 800 600 400 200 0

The poster area attracted many visitors 2nd

3rd

4th

5th

6th 7th 8th 9th WWW.EHAWEB.ORG

10th 11th 12th 13th

improvements in the diagnosis of ALL and the development of targeted, therapies. Tailored therapy for ALL is very important as 95 percent of people with the disease show individual patterns in their leukemic cells. This individualized approach, which Professor Hoelzer championed, has resulted in cure rates for ALL of 50 percent . The EHA-ASH policy forum in Copenhagen titled ‘Relation between academia and pharma: public trust at stake?’ focused on good governance. Both EHA and American Society of Hematology (ASH) have long standing, good relations with the pharmaceutical industry, which remains crucial for the core activities of both associations. M Greaves at the EHA-ASH policy forum

The Molecular Hematopoiesis Workshop was organized for the second year running. Following last year’s success a bigger room was allocated and again the room was filled to capacity with enthusiastic delegates. The aim of this workshop is to present cutting edge hematological science in a new and dynamic way. Thanks to the efforts of both speakers and or-

ganizers (Tariq Enver, Tony Green, Dan Tenen and Ivo Touw) an exciting addition has been made to regular congress educational sessions. The meet-the expert sessions were successfully moved to lunch hours, with participants appreciating the interactive opportunities they provided.

Exhibition area

The EHA booth in the Center Hall

N Borregaard, Congress President

EHA Newsletter November 2008 > 13

Abstract selection Abstract selection

10 countries: Top 10Top countries: abstracts •

13th

abstracts

Abstracts selection 13th Congress in Copenhagen

2008:

2007:

Italy

369

299

•

Spain

131

146

•

Greece

102

115

•

United Kingdom

101

114

•

Germany

99

134

•

France

76

103

•

United States of America

84

62

•

Czech Republic

74

74

•

Romania

60

39

•

The Netherlands

58

24

in Copenhagen 13th Congress Congress in Copenhagen

274

488

274

488

145

145

Oral

Oral

Poster

Poster

Only PublicationPublication Only

884

884

Rejected Rejected

It is our privilege to express our gratitude to the sponsors of the meeting, the Scientific Program Committee, the Advisory Board, the Local Organizing Committee, EHA Board and Executive Office and all the individuals who worked so hard to make WWW.EHAWEB.ORG WWW.EHAWEB.ORG the 13th Congress of EHA a resounding success.

The 13th Congress also providedWWW.EHAWEB.ORG a platform for European working groups and network meetings. Besides scientific sessions there were also many other possibilities to meet, including the social evening, the Farewell Lunch, the exhibition Participation devided by age and poster sessions.

Niels Borregaard Congress President 13th Congress

Gilles Salles Chair Scientific Program Committee 13th Congress

Participation divided by age 1961-1970 33%

1951-1960 34%

1920-1930 1931-1940 1941-1950 1951-1960 1961-1970

1941-1950 11% 1931-1940 1981-XXXX 1% 1920-1930 1%

1971-1980 19%

1971-1980 1981-XXXX

1%

WWW.EHAWEB.ORG

Nearly all the sessions were webcasted

14 > EHA Newsletter November 2008

D Hoelzer receives the Jean Bernard Lifetime Achievement Award

Collaboration between EHA and the European School of Haematology (ESH) EHA and the European School of Haematology (ESH) have collaborated on several projects in the past. In February 2008 the Joint Executive Committee was established to formalize the collaboration for future events and new projects. The committee representing both organizations includes W Fibbe, R Foà, E Gluckman and B Löwenberg. Selection of topics for workshops and development of new initiatives are amongst the most important tasks of this committee.

>  Scientific workshops are smaller scale meetings on dedicated topics of relevance for hematology. They are intended to promote informal interaction and discussion between scientists and clinicians working in the field. Another part of joint projects are the interactive hematology tutorials. Hematology tutorials are annual courses aiming to provide laboratory and clinical hematologists with an integrated diagnostic and clinical work-up of hematological disorders.

ESH-EHA Joint Activities in 2009 ESH-EHA Scientific Workshop: Leukemic and Cancer Stem Cells

A new logo was designed to give ‘face’ to the new style collaboration.

ESH-EHA Scientific Workshop: Innovative Therapies for Red Cell and Iron Related Disorders

ho ol

of

Haem

atology

Eu r

Europ

ea

ESH-EHA Hematology Tutorial: Hematology Tutorial on Lymphoid Malignancies May 15 - 17, 2009, Tallinn, Estonia Chairs: R Foà, E Kimby and G Zini

November 6 – 8, 2009 Coordinators: Y Beuzard and C Camaschella

tology A Hema sso cia t

ion

n ea op

April 3-5, 2009, Mandelieu, France Chairs: C Chomienne, D Bonnet, P Valent and D Louvard

c nS

ESH-EHA Annual Diagnostic Workup of Hematological Malignancies: Focus on Chronic Diseases Autumn 2009 Chairs: B Bain, R Foà, G Zini For information on the tutorials or workshops please visit: www.esh.org or www.ehaweb.org

Tutorials are part of the joint activities by EHA and ESH.

EHA Newsletter November 2008 > 15

‘Letter to the Editor’ > The EHA Newsletter encourages its readers to share their opinions through letters to the editor. We would like to hear your ideas on any topic in hematology. We would also appreciate your views on the Newsletter, favorable or not! Letters must be short (maximum of 300 words) and may be edited. If you are interested in having your Letter to the Editor pub-

lished, please be sure to include your full name and accurate contact information. Anonymous letters to the editor cannot be published. E-mail us at [email protected] The EHA Newsletter Editors Shaun McCann Catherine Lacombe

Cover photographs Please be encouraged to send in your scenic photographs for future newsletter covers (size: standing). The EHA offers € 100 for the photograph chosen as cover photo, starting next issue. November 2008

May 2008

November 2007

May 2007

Croatia Adriana Neghina (RO)

United States Marc Rudoltz (USA)

Denmark Martin Lorenzen (DK)

Switzerland Karin Amrein (CH)

EHA Members 3,000 Benefits of EHA Membership - Subscription to Haematologica/ The Hematology Journal (impact factor 5.516) - Reduction of € 180 on the individual registration fee for the EHA Annual Congress (junior members receive a reduction of € 105). - Eligible to apply for EHA Research Fellowships & Grants - Entitled to apply for a scholarship to attend ESH-EHA Scientific Workshops - EHA Newsletter - Access to the webcast of the EHA annual congress - Access to the EHA membership database

16 > EHA Newsletter November 2008

Overview EHA Committees and Units EHA CME Unit

EHA Nomination Committee

F Lo Coco, Italy (Chair) D Loukopoulos, Greece J Musial, Poland A Prentice, United Kingdom

I Pabinger, Austria (Chair) A Biondi, Italy M Björkholm, Sweden B Löwenberg, The Netherlands A Urbano Ispizua, Spain

EHA Corporate Sponsor Committee U Jäger, Austria (Chair) E Berntorp, Sweden H Döhner, Germany I Touw, The Netherlands

EHA Curriculum Committee E Hellström-Lindberg, Sweden (Chair) L Degos, France C Hok Toh, United Kingdom W Ludwig, Germany P Rebulla, Italy A Urbano Ispizua, Spain

EHA Education Committee A Green, United Kingdom (Chair) M Arat, Turkey E Berntorp, Sweden C Chomienne, France C Craddock, United Kingdom L Degos, France W Fibbe, Netherlands E Hellström-Lindberg, Sweden D Jasmin, France F Lo Coco, Italy H Serve, Germany

EHA Press Committee 2009 A Hagenbeek, The Netherlands (Chair) R. Hehlman, Germany W Fibbe, The Netherlands I Roberts, United Kingdom R Skoda, Switzerland

EHA Scientific Program Committee 14th Congress (SPC)

C Lacombe, France (Chair) C Camaschella, Italy I Touw, The Netherlands

EHA Scientific Program Committee Advisory Board 14th Congress

EHA Local Organizing Committee 14th Congress R Hehlmann, Germany (Congress President) B Dörken, Germany D Niederwieser, Germany E Thiel, Germany

EHA Membership Committee I Touw, The Netherlands (Chair) M Guenova, Bulgaria B Huntly, United Kingdom I Roberts, United Kingdom

G Zini, Italy (Editor) B Bain, United Kingdom W Erber, United Kingdom R Foà, Italy M Rozman, Spain M van ‘t Veer, The Netherlands

W Fibbe, The Netherlands (Chair) M Cazzola, Italy R Foà, Italy C Lacombe, France S McCann, Ireland

EHA Fellowships and Grants Committee

E Berntorp, Sweden (Chair) C Camaschella, Italy J Goldman, United Kingdom U Jäger, Austria E Montserrat, Spain

EHATol Unit

EHA Publication Committee

R Skoda, Switzerland (Chair) H Büller, The Netherlands C Chomienne, France J Cools, Belgium R Hehlmann, Germany (Congress President) F Lo Coco, Italy C Niemeyer, Germany I Peake, United Kingdom G Salles, France S Thein, United Kingdom M Theobald, The Netherlands

EHA Governance Committee

B Schlegelberger, Germany R Schlenk, Germany M Trneny, Czech Republic A Urbano Ispizua, Spain A Waage, Norway

N Avent, United Kingdom M Baccarini, Italy C Beamont, France E Berntorp, Sweden J Cornelissen, The Netherlands C Craddock, United Kingdom N Cross, United Kingdom T Enver, United Kingdom C Gachet, Italy G Gaidano, Italy P Ghia, Italy W Hofmann, Germany B Huntly, United Kingdom J Ingerslev, Denmark S Izraeli, Israel B Lämmle, Switzerland L Malcovati, Italy M Manz, Switzerland R Pieters, The Netherlands M Piris, Spain J San Miguel, Spain EHA Newsletter November 2008 > 17

Current members of the EHA Board Willem Fibbe – President 2007 – 2009 – The Netherlands

Upcoming Congresses Berlin

Robin Foà – President Elect 2007-2009 – Italy Eva Hellstrom-Lindberg – Past President 2007-2009 – Sweden Hartmut Döhner – Treasurer 2009-2010 – Germany Irene Roberts – Secretary 2006-2009 – United Kingdom Erik Berntorp – 2005-2009 – Sweden Clara Camaschella – 2007-2011 – Italy Christine Chomienne – 2007-2011 – France

> 14th Congress of the EHA Date: June 4-7, 2009 Place: Berlin, Germany Congress President: Prof R Hehlmann

Ulrich Jäger – 2006-2010 – Austria Catherine Lacombe – 2005-2009 – France Jorge Sierra – 2008-2012 – Spain

Barcelona

Radek Skoda – 2006-2010 – Switzerland Ivo Touw – 2006-2010 – The Netherlands

Colophon The EHA Newsletter is published by the European Hematology Association twice a year. Membership of the European Hematology Association includes subscription to the EHA Newsletter. Editors Editor-in-Chief Editor Sub-editor Editorial Coordination

Shaun McCann Catherine Lacombe Janet Fricker Ineke van der Beek

> 15th Congress of the EHA   Date: June 10 – 13, 2010 Place: Barcelona, Spain Congress President: Prof J San Miguel

London

Photography & Illustrations Cover Adriana Neghina MD, Romania (Plitvice National Park – Croatia) Congress photographs Moritz Wustinger Cartoon Jim Cogan Picture of tutorial Angela de Vlaming Printing Drukkerij BibloVanGerwen, ’s-Hertogenbosch Contact editors For general remarks, questions and suggestions e-mail [email protected] 18 > EHA Newsletter November 2008

> 16th Congress of EHA Date: June 9-12, 2011 Place: London, United Kingdom Congress President: Prof I Roberts

EHA Executive Office Carin Smand Managing Director

Ineke van der Beek External Affairs National Societies

Djowrain Bouterse Office Manager

Rik Craenmehr Congress Assistant

Thom Duyvené de Wit CME

Annemiek Kuijsten Annual Congress Sponsor Program

Ans Steuten Executive Management Fellowships & Grants

Liz Stokes Assistant to Managing Director

Petra Stork Publication & Communication

Angela de Vlaming Membership

Victoria Zhuravleva Education

Contact Information EHA Executive Office Westblaak 71 3012 KE Rotterdam The Netherlands Phone +31 (0)10 4361 760 Fax: +31(0)10 4361 817 E-mail: [email protected] Website: www.ehaweb.org

EHA Newsletter November 2008 > 19

the official newsletter for members of the EHA

Corporate Sponsors 2008 Gold Sponsors

Bronze Sponsor

EHA Executive Office Westblaak 71 3012 KE ROTTERDAM The Netherlands T. +31 (0)10 436 17 60 F. +31 (0)10 436 18 17 E. [email protected] W. www.ehaweb.org

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