Editor’s Note: From October 18 to 20, 2024, the 2024 Jiangsu Hematology Physicians Association Academic Conference was held in Taizhou, Jiangsu Province, focusing on the standardized diagnosis and treatment of hematologic diseases. Organized by the Jiangsu Hematology Physicians Association and hosted by the Affiliated Taizhou People’s Hospital of Nanjing Medical University and The First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial People’s Hospital), the conference provided a high-level academic exchange platform. Hematology Frontier invited Dr. Jianyong Li, Chairman of the conference and a distinguished expert from Jiangsu Provincial People’s Hospital, to share his insights on the event’s key highlights and discuss the current and future directions of hematology in China.

Hematology Frontier: As the chairman of the 2024 Jiangsu Hematology Physicians Association Conference, could you give us an overview of the main highlights and unique activities at this year’s conference, particularly concerning standardized diagnosis and treatment in hematology?

Dr. Jianyong Li: The conference was exceptionally rich in content, showcasing the latest research achievements in hematology from Jiangsu Province. The event opened with a case competition featuring 91 real-world clinical cases from hospitals across all levels, including grassroots institutions. This provided young physicians a platform to display their skills and facilitated in-depth discussions on implementing standardized and individualized treatment practices. The exchange and learning fostered among participants will undoubtedly enhance the clinical capabilities of young doctors.

Given the disparity in lymphoma treatment standards between China and other countries, we held a series of special lectures with provincial experts, who delivered systematic presentations on standardized treatment approaches for common diseases. They highlighted key steps and considerations in the standardized treatment process, offering valuable practice-oriented guidance for clinicians at all levels. These sessions aimed to improve both the professional expertise and clinical skills of healthcare providers across the province.

The conference also included an exciting segment focused on research advancements. Experts from Jiangsu Province shared significant achievements, including high-impact factor publications and notable presentations at international conferences like the American Society of Hematology (ASH). Over 67 high-quality research studies were showcased, highlighting Jiangsu’s contributions to hematology and creating an excellent platform for academic exchange and collaboration.

Hematology Frontier: You gave a keynote on “Standardized Diagnosis and Treatment of CLL” at the conference. Could you share the main challenges in promoting standardized care for CLL, and what specific actions are needed to strengthen this area?

Dr. Jianyong Li: The field of chronic lymphocytic leukemia (CLL) has advanced significantly in recent years. Treatment has evolved from alkylating agents and chemoimmunotherapy to a more chemo-free approach, integrating various therapeutic options. However, key challenges remain:

1. Accurate Diagnosis: It’s crucial to distinguish CLL from other lymphoproliferative disorders, as they can present similarly. Diagnosis must be verified through a systematic approach, including blood counts, smear analysis, flow cytometry, and lymph node biopsy if needed.
2. Prognostic Assessment: Beyond clinical assessments, genetic and molecular testing provides increasingly precise prognostic information. Integrating these advanced techniques into our prognostic assessment is essential. Peripheral blood testing, as opposed to bone marrow examination, offers a less invasive yet effective diagnostic approach, and we should leverage chromosome modeling and other advanced diagnostics.
3. Defining Treatment Indications: For patients without clear indications for treatment, an observation strategy should be adopted, as approximately one-third of CLL patients do not require immediate intervention. For those requiring treatment, the selection of an appropriate regimen is key. With advances in systemic treatment, CLL patient survival rates now approach those of the general population, making quality of life a priority.

We now have effective strategies, such as the lifelong BTK inhibitors. Fixed-duration therapies, like venetoclax ± obinutuzumab, are promising yet costly, which can be challenging for many patients. A cost-effective approach tailored to China involves using BTK inhibitors combined with FCG or FCR (e.g., fludarabine, cyclophosphamide, and either obinutuzumab or rituximab) for young patients with favorable prognosis, potentially achieving functional cures.

Finally, clinical trials should be actively promoted. Trials offer patients access to advanced therapies often provided at no cost, thereby easing their financial burden. Participation allows patients to contribute to the collective knowledge on CLL, accelerating progress in the field.

Hematology Frontier: This conference emphasized enhancing the diagnostic and treatment skills of grassroots physicians. What specific plans do you have to improve their capabilities and ensure cutting-edge knowledge and techniques reach grassroots patients?

Dr. Jianyong Li: Jiangsu Province, as a stronghold in both economic and cultural development, boasts balanced and high healthcare standards across various institutions. Our province hosts powerful national medical centers and clinical key specialties in hematology at Jiangsu Provincial People’s Hospital, The Affiliated Hospital of Xuzhou Medical University , and Zhongda Hospital of Southeast University. Additionally, over 20 county hospitals maintain hematology wards with at least 30 beds—a rarity in other regions.

To enhance the capabilities of grassroots medical units, we have established the Jiangsu Hematology Medical Association’s grassroots groups and lymphatic multi-disciplinary collaboration teams. These teams conduct regular professional training, academic exchanges, and case studies. By delving into real cases, we aim to elevate the skills of grassroots medical personnel, fostering progress in clinical practice.

We’ve also launched pilot MDT programs in select hospitals, offering multi-disciplinary support for newly diagnosed lymphoma patients. For initial diagnosis, relapsed or refractory cases, or when treatment plans need adjustment, we organize discussions either online or offline to optimize diagnosis and treatment. These efforts will significantly improve the clinical competency of grassroots medical units.

To further understand grassroots medical practices and boost research capabilities, we have initiated retrospective studies on lymphoma diagnosis and treatment, with results currently being summarized. Moving forward, grassroots units will be encouraged to participate in prospective clinical trials. With a collaborative, multi-level approach, Jiangsu’s hematology standards will continue to improve.

Hematology Frontier: As the president of the Jiangsu Hematology Physicians Association, how would you assess the current development of hematology in Jiangsu? What key areas should your colleagues focus on to advance the field?

Dr. Jianyong Li: Jiangsu has established a leading position in hematology. Suzhou, for instance, excels in areas like hematopoietic stem cell transplantation, leukemia treatment, thrombosis and hemostasis management, and cellular therapy. Jiangsu Provincial People’s Hospital also specializes in lymphoma and myeloma care, while The Affiliated Hospital of Xuzhou Medical University  has achieved breakthroughs in CAR-T cell therapy at an international level.

In lymphoma care, Jiangsu has established a collaborative group focused on geriatric lymphoma, led by Professor Shi Wenyu, with remarkable research and publications. As there remains limited attention on geriatric lymphoma in China, Jiangsu’s research outcomes are expected to have a global impact.

Another notable initiative is the study of lymphoma-associated hemophagocytic syndrome. Led by Professor Shi, the Hemophagocytosis Working Group has conducted a retrospective analysis on over 500 cases, a collection size that is unique internationally. The study has gained recognition and praise at top academic conferences, and prospective research will continue to drive the field forward.

We’re also establishing new working groups, including those focusing on lymphoma PET-CT, adolescent lymphoma, HIV-associated lymphoma, and plasma cell disorders. These collaborative networks aim to advance clinical research, driving treatment innovation in hematology. We encourage more institutions in Jiangsu to participate in these initiatives, fostering unique diagnostic and therapeutic approaches and ultimately improving the healthcare experience for patients.

About Dr. Jianyong Li

Dr. Jianyong Li is the Chair of the Hematology Department at Jiangsu Provincial People’s Hospital and a prominent figure in hematology, with extensive academic and clinical contributions. He serves as the President of the Jiangsu Hematology Physicians Association and has played a vital role in shaping guidelines and standards for hematology practice in China.