Graft Versus Host Disease Symposium and Canadian Blood Services Symposium

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1 Graft Versus Host Disease Symposium and Canadian Blood Services Symposium October 19 and 20, 2012, Montreal, Quebec T: F: E: 1

2 The Canadian Blood and Marrow Transplant Group would like to thank Sanofi for their exclusive support of the GVHD symposium West 5th Avenue, Suite 201, Vancouver, BC, V5Y 1J6 Canada

3 Table of Contents Welcome Letter...4 Executive Committee...4 Schedule-at-a-Glance...5 CBS Session Description...6 GVHD Session Description...7 Invitation to 2013 Conference...11 T: F: E: 3

4 Welcome Dear Colleagues, On behalf of the CBMTG Executive and GVHD symposium planning organizing committee, I am pleased to present the program for the 2012 GVHD Symposium. The CBMTG GVHD Symposium 2012 takes place October 19 and 20, 2012 at the W Hotel in Montreal, Quebec. You will note that this year we have also partnered with Canadian Blood Services who will present an afternoon symposium focusing on cord blood banking in advance of our symposia. Sessions that will be presented are Pharmacokinetics and pharmacodynamics of medications given for GVHD prophylaxis, Debate on ATG, Haplo-Identical Transplant Summary, Alternative Donors for Hematopoeitic Cell Transplantation: Optimizing the Choice Defining the Role of Sirolimus in the Management of Graftversus-Host Disease: from Prophylaxis to Treatment and How Can the Psychiatrist Help You on the BMT Unit. Please see the full program for session descriptions and biographies of our presenters. We look forward to the exciting symposium and look forward to this very interactive event. Sincerely, Jean Roy, MD, FRCPC Chair, GVHD Symposium Planning Committee CBMTG Executive Committee President, Silvy Lanchance, MD, FRCP, CSPQ Past President, Ronan Foley, MD, FRCP Treasurer, Andrew Daly, MDCM, FRCPC Secretary, Jennifer Wiernikowski, MN, NP-Adult, CON(C) The Canadian Blood and Marrow Transplant Group would like to thank Sanofi for their exclusive support of the GVHD symposium West 5th Avenue, Suite 201, Vancouver, BC, V5Y 1J6 Canada

5 Graft Versus Host Disease Symposium and Canadian Blood Services Symposium Montreal, Quebec, October 19 to 20, 2012 Friday, October 19, 2012 Schedule-at-a-Glance 12:00pm 1:00pm 1:00pm 4:00pm 1:00pm 2:00pm 2:00pm 3:00pm 3:00pm 3:30pm 3:30pm 4:30pm REGISTRATION Canadian Blood Services Symposium on Cord Blood Banking, Transplantation, and Regenerative Therapy Cord Blood Banking Session Cord Blood Transplantation COFFEE BREAK Research Using Cord Blood Canadian Blood Services OneMatch Public Cord Blood Bank Update Hema-Quebec, Cord Blood Banking Update Recent Issues in Best Practices in Cord Blood Banking How I Select Cord Blood Units for Transplantation Cord Blood Transplantation in Adults A Canadian Perspective Clinical Trials in Cord Blood Transplantation Cord Blood Cells for Regenerative Therapy Cord Blood MSCs and Treating Neonatal Pulmonary Disease Dr. Heidi Elmoazzen Dr. Martin Champagne Dr. Tanya Petrasko Dr. Juliet Barker Dr. Sandra Cohen Dr. Michel Duval Dr. David Allan Dr. Bernard Thebaud GRAFT VERSUS HOST DISEASE SYMPOSIUM, Sponsored by Sanofi 6:00pm 7:00pm REGISTRATION 7:00pm onwards Educational Session with Dinner Mobilization Dr. John Dipersio Saturday, October 20, :00am 8:30am REGISTRATION AND BREAKFAST 7:00am 8:00am Clinical Trials Network Meeting Part 1 Dr. Donna Wall 8:15am 8:30am Introduction Dr. Jean Roy 8:30am 9:15am Session 1 Pharmacokinetics and pharmacodynamics of medications given for GVHD prophylaxis Dr. Tal Schechter- Finkelstein Dr. Joachim Deeg and 9:15am 10:45am Session 2 Debate on ATG Dr. Robert Soiffer 10:45am 11:00am COFFEE BREAK 11:00am 11:45am Session 3 Haplo-Identical Transplant Summary Dr. Irwin Walker 11:45am 12:30pm Session 4 Alternative Donors for Hematopoeitic Cell Transplantation: Optimizing the Choice Dr. Thomas Spitzer 12:30pm 1:30pm LUNCH 1:30pm 2:15pm Session 5 Defining the Role of Sirolimus in the Management of Graft-versus-Host Disease: from Prophylaxis to Treatment Dr. Silvy Lachance 2:15pm 3:00pm Session 6 How Can the Psychiatrist Help You on the BMT Unit Dr. Arthur Sullivan and Dr. Lawrence Hoffman 3:00pm 3:15pm Concluding Remarks Dr. Jean Roy 3:30pm 5:00pm Clinical Trials Network Meeting Part 2 Dr. Donna Wall T: F: E: 5

6 Canadian Blood Services Symposium Montreal, Quebec, October 19 to 20, 2012 Canadian Blood Services Symposium on Cord Blood Banking, Transplantation, and Regenerative Therapy Canadian Blood Services is pleased to host a symposium that will provide an update on the status of public cord blood banking in Canada, the increasing role of cord blood in hematopoietic stem cell transplantation for pediatric and adult patients, and some highlights regarding future opportunities involving the use of cord blood. An Update on Cord Blood Banking in Canada, chaired by Dr. Martin Champagne In this session, updates on cord blood banking will be provided by Hema-Quebec and the Canadian Blood Services OneMatch Public Cord Blood Bank. We will hear how Canada is emerging as a partner in the global activity of public cord blood banking and we will hear about recent developments in banking practices that strive to improve the quality of available units. 1:00pm 1:05pm 1:05pm 1:20pm Introductory remarks David Allan Dr. Heidi Elmoazzen, Canadian Blood Services, Ottawa OneMatch Public Cord Blood Bank an update on a work in progress 1:20pm 1:40pm Dr. Martin Champagne, Hema-Quebec An update on the Hema-Quebec Cord Blood Bank 1:40pm 2:00pm Dr. Tanya Petraszko, Vancouver ` A review of best practices in cord blood banking current issues. Recent Trends in Cord Blood Transplantation, chaired by Dr. Jean Roy Cord blood transplantation practices for pediatric and adult patients will be addressed in this session and we will hear some practical advice regarding how to select units for transplantation. 2:00pm 2:40pm 2:40pm 3:00pm 3:00pm 3:20pm Dr. Juliet Barker, MSKCC, New York How I select cord blood units for transplantation Dr. Sandra Cohen, Montreal, Cord blood transplantation in adults - a Canadian perspective Coffee Break Research Using Cord Blood, chaired by Dr. David Allan Cord blood is increasingly considered for novel applications, both in the realm of hematopoietic stem cell transplantation and for emerging applications in regenerative therapy. We will hear some of the cutting edge uses of cord blood cells in this session. 3:20pm 3:40pm 3:40pm 4:00pm 4:00pm 4:30pm Dr. Michel Duval, CHUM-St. Justine, Montreal Clinical trials in cord blood transplantation Dr. David Allan, Ottawa Cord blood cells for regenerative therapy Dr. Bernard Thebaud, Edmonton Cord blood MSCs and treating neonatal pulmonary disease West 5th Avenue, Suite 201, Vancouver, BC, V5Y 1J6 Canada

7 Graft Versus Host Disease Symposium Montreal, Quebec, October 19 to 20, 2012 Friday, October 19, 2012 GVHD Symposium Session Summaries 7:00pm onwards Educational Session with Dinner Mobilization John F. DiPersio, MD, PhD This session will focus on the basic science of stem cell mobilization, the current state of the art for clinical autologous and allogeneic stem cell mobilization, novel approaches, small molecules and combinational therapies to optimize stem cell mobilization and the use of novel stem cell mobilization platforms to sensitize murine and human acute leukemia to chemotherapy. Dr. Di Persio is Chief of Division of Oncology at Washington University School of Medicine. His research focuses on fundamental and translational aspects of leukemia and stem cell biology. These studies include identification of genetic abnormalities in human leukemias, understanding processes involving stem cell and leukemia cell trafficking and clinical and translational programs in both leukemia/mds and stem cell transplantation. His laboratory utilizes unique mouse models of allogeneic stem cell transplantation to explore novel genetic and epigenetic interventions aimed at mitigating graft vs. host disease (GVHD) while maintaining graft vs. leukemia (GvL). He serves as co-chair of the Basic Biology Committee of the second NIH-Consensus Conference on Relapse after Allogeneic Stem Cell Transplantation (2012). Dr. DiPersio has an extensive publishing history. Saturday, October 20, :15am 8:30am Introduction Jean Roy, MD, FRCPC Dr. Jean Roy is Professor of Medicine at the University of Montreal. He received his medical degree from Laval University in Quebec City and subsequently trained in both internal medicine and hematology at McGill University. In 1989, he moved to Minneapolis to complete a fellowship in stem cell transplantation at the University of Minnesota with Drs. Daniel Weisdorf and Bruce Blazar. Since his return to Canada in 1993, he has been actively involved in clinical research in the field of allogeneic transplantation, as well as with the Canadian Blood and Marrow Transplant Group. He acts regularly as a scientific editor and advisor. His special interest is in allogeneic transplantation and multiple myeloma. 8:30am 9:15am Session 1 Pharmacokinetics and pharmacodynamics of medications given for GVHD prophylaxis Tal Schechter-Finkelstein, MD Despite prophylaxis, acute graft versus host disease (GVHD) remains a major cause of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplantation. This talk will discuss the research done to better understand the pharmacokinetics and pharmacodynamics of medications given to prevent GVHD with focus on cyclosporine A and antithymocyte globulin. Dr. Tal Schechter-Finkelstein is a staff physician in the Pediatric Blood and Marrow Transplant Unit at The Hospital for Sick Children, Toronto since Dr. Schechter-Finkelstein received her medical degree at the Hebrew University of Jerusalem Medical School in Israel and subsequently trained in Paediatrics at Schneider Medical center, Tel-Aviv University. Following her residency, she was a visiting scholar in the BMT unit at Children s Memorial, North Western University, Chicago. She subsequently did her pediatric hematology-oncology fellowship and clinical pharmacology training at The Hospital for Sick Children between 2005 and Her main clinical and research arenas are in the fields of GVHD treatment response and pharmacokinetic studies of medication related to conditioning regimens and medications given to prevent GVHD. T: F: E: 7

8 Graft Versus Host Disease Symposium Montreal, Quebec, October 19 to 20, :15am 10:45am Session 2 Debate on ATG Joaquim Deeg, MD and Robert J. Soiffer, MD Clinical studies over at least three decades have shown that one beneficial aspect of the allogeneic reaction of donor cells against the host is the impact on residual leukemia (or other tumor) cells in the patient. In fact, this GvL effect appears to be essential in eradicating the patient s underlying disease, more so with reduced intensity conditioning than with higher intensity regimens. What has been challenging, however, is the separation of this GvL effect from GVHD. The most effective regimens used to prevent GVHD, in vitro T cell depletion, have been associated with the highest relapse rates, comparable to those observed with syngeneic transplants, that is in the absence of an allogeneic reaction. More promising in this respect have been approaches of in vivo T cell depletion (or inactivation), for example with monoclonal antibodies or polyclonal preparations, such as anti-thymocyte globulin (ATG). In vivo strategies may allow for a certain level of reactivity of donor cells (T cells, NK cells) against the patient s disease, while still allowing for suppression of GVHD. However, recent studies have yielded conflicting results with the use of ATG, and additional studies will be necessary. New data on the selective elimination of naïve T cells, again an in vitro strategy, look promising in regards to the prevention of both (severe) GVHD and relapse. It appears, however, that other well recognized factors need to be further investigated. Dr. Joaquim Deeg is Professor of Medicine at the University of Washington, and a Member of the Clinical Research Division at the Fred Hutchinson Cancer Research Center, Seattle. He earned his medical degree from the University of Bonn, Germany, then completed internal medicine training and was Chief Medical Resident at the University of Rochester School of Medicine, N.Y. He did his Hematology/Oncology fellowship under E.D.Thomas at the University of Washington, Seattle, where he then joined the faculty. He subsequently developed a transplant unit at Georgetown University in Washington DC, and after a short term, at the University of British Columbia and as Director of the Immunology Laboratory at Vancouver General Hospital. He subsequently returned to the Fred Hutchinson Cancer Research Center in Seattle. Dr Deeg has worked and published extensively on clinical and pre-clinical models of transplantation, conditioning regimens, GVHD, the pathophysiology and therapy of marrow failure, late complications of cancer therapy and related questions. He has published more than 750 scientific papers. Dr. Robert J. Soiffer received his MD from the New York University School of Medicine. He completed his residency in internal medicine at Brigham and Women s Hospital where he also served as Chief Medical Resident. He completed fellowship in medical oncology at Dana-Farber Cancer Institute (DFCI). Dr. Soiffer is currently Professor of Medicine at Harvard Medical School and Chief of the Division of Hematologic Malignancies. He is also Co-Director of Bone Marrow Transplant Service at DFCI. Dr. Soiffer s research focuses on modulation of immune responses in the setting of hematopoietic stem cell transplantation. The ultimate goal for his clinical trials and research grants is to optimize graft versus leukemia activity without inducing graft-versus-host disease. He is a former President of the American Society for Blood and Marrow Transplantation, and serves on the advisory board for the Center for International Blood and Marrow Transplant Research and the Executive Steering Committees for Blood and Marrow Transplant Clinical Trials Network. Dr. Soiffer has co-authored over 200 peerreviewed manuscripts and numerous book chapters, review articles, editorials, and monographs West 5th Avenue, Suite 201, Vancouver, BC, V5Y 1J6 Canada

9 Graft Versus Host Disease Symposium Montreal, Quebec, October 19 to 20, :00am 11:45am Session 3 Haplo-Identical Transplant Summary Irwin Walker, MD This session is a review of the rationale for haplo BMT. The question of which haplo protocol should be used will be reviewed and examined. Dr. Irwin Walker is Professor of Medicine at McMaster University, Hamilton. He graduated from Melbourne University in 1965 and completed hematology training at McMaster in He has been involved in bone marrow transplantation, as physician since 1981, as head of the Hamilton program since 1994, as Chair of the CBMTG Strategic Planning Committee in 1998 and as President of Canadian Blood and Marrow Transplant group (CBMTG) from 2002 to Currently, he is the principal investigator for the CBMTG 0801 clinical trial for prevention of chronic GVHD. Other positions have included Chief of Medicine at McMaster University Medical Centre, and Chair of the Medical Scientific Advisory Committee to the Canadian Hemophilia Society. 11:45am 12:30pm Session 4 Alternative Donors for Hematopoeitic Cell Transplantation: Optimizing the Choice Thomas R. Spitzer, MD The striking expansion of indications for hematopoietic cell transplantation (HCT) has been fueled by reduced intensity conditioning regimens allowing for the transplantation of older patients or sicker patients and by the use of alternative (non HLA-matched related or unrelated) donors. For patients who have a clinical indication for HCT but do not have an HLA-matched donor, consideration is often given to an umbilical cord blood, haploidentical related donor or mismatched unrelated donor source of stem cells. While acceptable outcomes after these alternative donor transplants have been observed, crossing HLA barriers is still problematic and associated with more complications. This discussion will focus on the results of alternative donor transplants and offer strategies for choosing the optimal donor for patients who lack an HLA-matched donor. Dr. Thomas Spitzer is Director of the Bone Marrow Transplant Program at the Massachusetts General Hospital (MGH) and Professor of Medicine at Harvard Medical School. He is also Walter Bauer Firm Chief in the Department of Medicine. Dr. Spitzer received his Bachelor of Science degree in Biology from Bucknell University and his M.D. from the University of Rochester School of Medicine. He completed his internship and residency in Internal Medicine at New York Hospital-Cornell Medical Center and Memorial-Sloan Kettering Cancer Center and his Hematology-Oncology fellowship at Case Western Reserve University. He was formerly the Director of the Bone Marrow Transplant Program at Georgetown University Hospital and since 1992 has been Director of the Bone Marrow Transplant Program at the MGH. His primary academic interests include the development of novel strategies for performing stem cell transplants across HLA barriers for hematologic malignancies and for inducing specific tolerance for organ transplantation by performing combined bone marrow and kidney transplants. T: F: E: 9

10 Graft Versus Host Disease Symposium Montreal, Quebec, October 19 to 20, :30pm 2:15pm Session 5 Defining the Role of Sirolimus in the Management of Graft-versus-Host Disease: from Prophylaxis to Treatment. Silvy Lachance, MD, FRCPC Sirolimus (rapamycin) is a lipophilic macrocytic lactone with immunosuppressive, anti-tumor and anti viral properties. Because of its multiple modes of activities, it is being increasingly used in the management of GVHD. Sirolimus mechanisms of action and potential advantages over other immunosuppressors will be discussed and its role in both prevention and treatment of GVHD reviewed. Dr. Silvy Lachance completed hematology training at University of Montreal in 1992, followed by a Fellowship in stem cell transplantation at Henri-Mondor University Hospital in Paris, where she worked with Professor Jean-Paul Vernant and Professor Jean-Pierre Farcet. In 1994, she completed a DEA in immunology at Pasteur Institute. She joined the Department of Medicine of the University of Sherbrooke in 1995, and established its first BMT unit. In 1997, she joined the Hematology and Oncology Division of the Montreal General Hospital as a transplant physician and became Associate Professor at McGill University. She joined the stem cell transplant team of Maisonneuve-Rosemont Hospital in June 2006 and became transplant director in She is actively involved with the Canadian Blood and Marrow Transplant Group; she became the President of the association in :15pm 3:00pm Session 6 How Can the Psychiatrist Help You on the BMT Unit Arthur Sullivan, MD and Lawrence Hoffman, MD In this session, we will review some of the rationale and evidence for how conscious and unconscious mental functioning influence an individual s response to the toxic and microbial stresses associated with bone marrow transplantation. Dr. Arthur Sullivan graduated from University of Vermont College of Medicine in 1971, and then completed medical residency and clinical hematology fellowship at McGill University. After research fellowships in immunochemistry at McGill and the National Institute for Medical Research in Mill Hill, UK, he returned to a staff position in the Division of Hematology at the Royal Victoria Hospital, and directed a research program studying various aspects of bone marrow biology at the McGill Cancer Centre. It was there that collaboration with Dr. Lawrence Hoffman, a psychiatrist, led him to investigate some of the psychodynamic factors influencing the course following BMT. In 1997, he left McGill to become director of the acute leukemia service at the King Faisal Specialist Hospital in Riyadh, Saudi Arabia. He then went on to the University of Washington in Seattle to complete a residency in psychiatry. He joined the Department of Psychiatry at University of Toronto and Princess Margaret Hospital in 2000, working closely with the BMT group. For the past 6 years Dr. Sullivan has been in private practice in psychiatry in Ottawa. Dr. Lawrence Hoffman is a graduate of McGill University, Faculty of Medicine. After completing his psychiatry residency training at McGill, he joined the Department of Psychiatry at the Allan Memorial Institute, specializing in consultation liaison in medically ill patients. This led him to develop a special interest in mind-body issues in cancer patients, and initiated efforts that eventually led to the development of a psycho-oncology program at McGill. Dr. Hoffman has extended his interest to liver transplantation psychiatry and continues to advise the BMT program at the Royal Victoria Hospital West 5th Avenue, Suite 201, Vancouver, BC, V5Y 1J6 Canada

11 2013 WINN PEG April 10 to April 13, 2013 Fort Garry Hotel Annual Conference Canadian Blood and Marrow Transplant Group We invite all BMT health care professionals to attend our conference in Winnipeg The Conference Planning Committee, led by Dr. Donna Wall and the Manitoba BMT team, is finalizing an exciting program that will feature presentations on the latest developments in BMT patient care and clinical and laboratory research breakthroughs. The format for the 2013 CBMTG conference will include scientific plenary sessions, keynote presentations, multidisciplinary and discipline-specific sessions, oral research presentations, committee and society meetings and corporate satellite sessions. Canadian Blood and Marrow Transplant Group Société canadienne de greffe de cellules souches hématopoïétiques CBMTG Head Office Malachite Management Inc 375 West 5th Avenue Suite 201, Vancouver BC Canada V5Y 1J6 T F Web: T: F: E: 11

12 Graft Versus Host Disease Symposium and Canadian Blood Services Symposium October 19 and 20, 2012, Montreal, Quebec West 5th Avenue, Suite 201, Vancouver, BC, V5Y 1J6 Canada T: West F: th Avenue, Suite E: 201, Vancouver, BC, V5Y 1J6 Canada

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