Day 2 #ISTH2019: Running, Bleeding and Posters

Day 2 got off to a racing start, with a chilly early-morning charity fun run. With the goal of raising funds and awareness for World Thrombosis Day, hundreds trekked to the Melbourne Botanical Gardens to enjoy a casual five kilometer walk or jog — in the dark at 6am. That should be sure to help with any remaining jet-lag!


Published 9 July 2019 | 3 min read

With the run over, I headed back to the convention centre for another busy day of sessions and presentations. Over the course of the day, I enjoyed sessions such as the State-of-the-Art talk on Congenital and Acquired Thrombocytopenias. In particular, I liked the session on Inherited Thrombocytopenia Syndromes, given by Patrizia Noris, which focused on some of the newly described genetic links. I was also intrigued by Jenny M. Despotovic, who highlighted some recent evidence in Immune Thrombocytopenia in Children and demonstrated why the treatment recommendations are as they currently are. Working in the haemotology field it is important to keep up with recommendations and guidelines, as our work has the potential for real change to people’s lives.

"I will be glad when the updated ASH guidelines are available later in the year, concreting and validating the advice we as haematologists give to our colleagues in the management of this very common condition."

I have enjoyed listening to such discussions, which can inform and make real changes to clinical practice — it is exciting to be a part of something that can have such a visible impact.

The third plenary for the congress was given by Professor Marie Scully from London, where we learnt of encouraging new knowledge and research about a rare and devastating haematologic condition. Professor Scully discussed the open conformation of von Willebrand factor-cleaving protease (ADAMTS13) and how this can play a major role in the pathophysiology of this disorder. The benefit of rituximab as part of treatment in acute immune mediated thrombotic thrombocytopenic purpura (TTP) was also highlighted, as well as plasma in pregnancy associated TTP.

"I felt encouraged and inspired by the recent evidence presented; I look forward to seeing what the future of therapy will bring for patients in this rare situation."

Keeping to the theme of congenital abnormalities, we also heard about mutations and pathophysiology of congenital TTP, as well as management strategies and successes in managing this condition. As Dr Chris Ward put it in his introduction to the Barry Firkin Plenary Lecture, thrombotic microangiopathies are one of the most terrifying and gratifying disorders we deal with as haematologists — it is always interesting to hear expert opinions on such a poignant matter.

I also attended a few sessions related to paediatric haemostasis. The oral presentation session on Bleeding and Clotting Complications in children was enlightening; I was intrigued to hear about microRNAs and their association with risk in severity of intraventicular haemorrhage in neonates. This is a complication of prematurity that I manage daily in my work in paediatric medicine, and so hearing of recent evidence in the field is always pertinent.

"It will be interesting to see what further research and clinical practice this will prompt; it is gratifying to think that new knowledge and research can translate into real change for patients."

I also enjoyed the USA study data on community acquired venous thromboembolism (VTE) in children, presented by Marilyn Manco-Johnson. Given that this is such a controversial topic in haematology clinical practice, I was curious about the data on diagnosed thrombophilia and corresponding incidence of VTE.

The poster session on the evening of day 1 was a huge success! I was particularly interested in several posters relating blood group and the proposed corresponding reduced risk of thrombotic complications. As well as this, I enjoyed discussions relating to von Willebrand factor, and how this may be a contributing factor.

"I feel there’s a lot more to know in this area, and such knowledge may lead to a change in practice."

Tonight I am excited for my own poster presentation, followed by a networking event catching up with some international colleagues!