Editor’s note: With the development of targeted therapy and immunotherapy, the treatment options for malignant hematologic diseases continue to expand. The “Chinese Society of Clinical Oncology (CSCO) Guidelines for the Diagnosis and Treatment of Malignant Hematologic Diseases (2024)” has once again been updated. “Oncology Watch” specially interviewed one of the guideline’s authors, Professor Tiejun Gong from the Harbin Institute of Hematology and Oncology, to provide in-depth explanations on the highlights of the guideline updates, their impact on clinical practice, and the implementation of the guidelines.

“Oncology Frontier”: It has been four years since the first edition of the “CSCO Guidelines for the Diagnosis and Treatment of Malignant Hematologic Diseases” was published. What developments and changes do you think the guidelines have undergone, and what impact have they had on improving standardized diagnosis and treatment in China?

Professor Tiejun Gong: The “CSCO Guidelines for the Diagnosis and Treatment of Malignant Hematologic Diseases” have been published for four years. These guidelines represent the concerted efforts of numerous experts in hematology across the country. It is well known that although hematology is a smaller discipline, the progress in the diagnosis and treatment of hematologic malignancies is among the fastest in the entire field of oncology. Over the past four years, targeted therapy, immunotherapy, antibody-drug conjugates (ADCs), and chimeric antigen receptor T-cell (CAR-T) therapy have all been applied clinically. Overall, the “CSCO Guidelines for the Diagnosis and Treatment of Malignant Hematologic Diseases” have undergone significant development and changes over these four years, with 20% to 40% of the content being updated annually. Compared to other oncology guidelines, they are updated most frequently and rapidly. We hope that the progress of the guidelines will greatly benefit clinical doctors, especially those at the grassroots level.

“Oncology Frontier”: Leukemia is one of the common malignant hematologic diseases in China, and updates to the guidelines are of particular concern to clinical doctors. Could you introduce the important updates in the leukemia field in the new version of the guidelines?

Professor Tiejun Gong: Compared to the fields of lymphoma and myeloma, progress in the field of acute leukemia has been slightly slower. However, we are pleased to see that acute lymphoblastic leukemia has also seen updates with the introduction of bispecific antibodies, ADCs, CAR-T, TKIs, and other drugs, bringing benefits to patients with various types of acute lymphoblastic leukemia. In the field of acute myeloid leukemia, drugs such as venetoclax, gilteritinib, ivosidenib, and sorafenib have been applied and marketed, and we have also updated and refined the guidelines accordingly. With limited “weapons” for treating leukemia, the focus in recent years has been on when and how to use these “weapons” to maximize benefits for patients.

“Oncology Frontier”: In recent years, CAR-T therapy has made many breakthroughs in the treatment of malignant hematologic diseases. Could you introduce the current situation of CAR-T clinical research and practical applications in China? What are the future prospects?

Professor Tiejun Gong: CAR-T therapy is a source of pride for China. We have conducted the most research, collected the most comprehensive data, and published the most articles in this field. Previously, CAR-T therapy was included in the guidelines for malignant hematologic diseases mainly for its use in targeting CD19 in lymphoma treatment. Starting from this year, CAR-T therapy has been applied in the treatment of lymphoma, acute lymphoblastic leukemia, and myeloma, so we have compiled a separate manual for CAR-T therapy to help doctors understand CAR-T-related drugs, protocols, indications, complications management, and full-course management. We hope to continue refining this field so that CAR-T therapy can be used reasonably and fully in the hands of doctors as an effective tool for treatment.

“Oncology Frontier”: Could you introduce how the new version of the “CSCO Guidelines for the Diagnosis and Treatment of Malignant Hematologic Diseases” will be implemented, reaching clinical practice and grassroots levels, so that more doctors can use the guidelines effectively and play their role?

Professor Tiejun Gong: The ultimate goal of our guideline development is to enable doctors, especially those at the grassroots level, to conduct simple treatments based on a pocket guide and to be exposed to standardized and cutting-edge diagnostic and treatment concepts. CSCO has conducted 20 to 30 nationwide lectures on malignant hematologic diseases such as leukemia and myeloma. In addition, the guidelines have been refined in various fields. We hope to promote the essence of the guidelines to municipal hospitals and county hospitals with hematologic departments, so that these doctors can carry out individualized treatment under standardized conditions and apply new treatment advances through the guidelines. This will greatly help improve the quality of doctors and benefit patients. Overall, in terms of supplementing and updating the guidelines, we are making progress year by year, moving towards maturity. The experts involved in guideline development conduct very detailed content updates every year, with even minor advancements and changes being extensively reflected in the guidelines. Looking back at the changes in the guidelines over the years, we can clearly see the significant progress in the treatment of hematologic malignancies, and we hope that everyone can benefit from the newly released guidelines.

Professor Tiejun Gong

Associate Director, Harbin Institute of Hematology and Oncology

Member of the 9th and 10th Youth Committee of the Hematology Branch of the Chinese Medical Association

Member of the Hematology Physician Branch of the Chinese Medical Doctor Association

Standing Committee Member of the Hematologic Oncology Special Committee of the Chinese Anti-Cancer Association

Standing Committee Member of the Hematologic Malignancies Transformation Special Committee of the Chinese Anti-Cancer Association

Deputy Director of the Anti-Leukemia Lymphoma Alliance Youth Committee of the Chinese Society of Clinical Oncology (CSCO)

Secretary of the Leukemia Expert Committee and Member of the Lymphoma Expert Committee of the Chinese Society of Clinical Oncology (CSCO)

Standing Committee Member of the Hematology Department of the Chinese Hospital Association

Member of the Expert Committee on Oncology Capacity Building and Continuing Education of the National Health Commission

Communications Editor of the “Chinese Journal of Hematology” and Editorial Board Member of “Leukemia Lymphoma”

Vice Chairman of the Hematology Branch of the Heilongjiang Medical Association

Deputy Director of the Lymphoma Myeloma Special Committee of the Heilongjiang Medical Doctor Association

Deputy Director of the Anti-Leukemia Lymphoma Alliance in Heilongjiang Province of the Chinese Society of Clinical Oncology (CSCO)