Passing the Baton and Looking for a New Future: A Final Message from Dr. Navneet Majhail

I go through a myriad of emotions as I collect my thoughts and write my final blog as the President of the ASTCT. I feel grateful for this opportunity to serve the society and our field. I feel thankful for all the new friends I have made over the past year and the relationships I have strengthened, both at home and abroad. I feel invigorated by all of you, our society members – you put in an incredible amount of time and effort volunteering for the society. I feel optimistic as I see the energy and ideas among our trainees and young members. There is a tinge of regret, since I wish I could have done more. I feel somewhat tired and am ready to relinquish the reins of the society to Dr Reddy. And I feel sorry, I did not tweet as much as our other President!

Instead of feeling nostalgic and reflecting on what the ASTCT has done over the past year, I will focus on where we are going and the opportunities that lay ahead. First, the transition from ASBMT to ASTCT has gone really well. I have to congratulate our Board for having the foresight to proceed with this in 2018. We all know that we have just scratched the surface as we consider the therapeutic potential of cellular therapies, and the society is well positioned to continue its leadership in research, education, training and advocacy in this area as the horizon expands beyond hematologic malignancies.

Earlier this year, we announced that our flagship journal is changing its name from Biology of Blood and Marrow Transplantation to Transplantation and Cellular Therapy in January 2021. The Board also approved hiring of a Deputy Editor who will be announced soon and will work with Dr. Korngold and the Editorial Board to enhance the profile of our journal in the cellular therapy space. There will be a lot of effort this coming year to strengthen the journal as we go through this transition. You can start deconditioning your brains from “BBMT” and get more used to saying “TCT”!

As much as we are excited about cellular therapies, the society will continue to focus on traditional BMT – we have more patients than ever who can benefit and there are emerging indications where we can help more patients. However, there remain significant barriers to access to transplantation and cellular therapies, and the society will continue to chip away at them. The high costs of these therapies, the associated financial toxicity, and coverage and reimbursement for what we do, continue to be major issues and we will continue to advocate for our patients at the national and local level.  

Research and science are so critical for our field and for our patients. This is why I and I am sure many of you were intrigued by our field to begin with. Supporting and disseminating research will continue to be a part of the core mission of the ASTCT, especially as we realize the potential for cellular therapy. I am particularly excited about Dr. Reddy’s presidency and his ideas in this area. Please continue to support our Giving Campaign, since that will fund our New Investigator Awards, among other things.

Capacity, that is people and infrastructure, is emerging as another challenge that we need to grapple with so that we can continue to provide the high-quality care that transplant programs are known for. Also a throwback to 2010, when the NMDP organized “System Capacity Initiative: HCT in 2020” in collaboration with our society and other organizations to come up with ideas for addressing this very issue – hard to believe we are in 2020 already! The society will have more conversations around this topic, given its importance in ensuring access for our patients.

Education is something that our society is uniquely poised to do – for the whole spectrum of our members – physicians, researchers, pharmacists, nurses, APPs, administrators, social workers, etc. The new website is structured to facilitate education and training. The TCT meetings keep getting better and bigger every year. The ASTCT has invested heavily in this space so that we will be able to provide more educational offerings across the spectrum of in-person meetings to online content. Among other things, our new website is designed to facilitate dissemination of webinars and podcasts and we are in the process of becoming a CME provider. I do have to call out many of our SIGs who do an incredible job of putting together high-quality educational programs for the society.

None of the above is sustainable without ensuring we support our trainees and younger members (for the record, I consider myself young and I am not eligible for AARP membership … yet!). The society recently implemented a governance policy to ensure we keep injecting “new blood” into our committees and SIGs. This policy will also move us closer to where we want to be with respect to diversity and inclusivity within the society – an issue the society leadership continues to be very passionate about.

I have always shared a patient story, and I would be remiss if I don’t include one in my last blog. So let me tell you about Frank. Frank had advanced MDS and at the time of diagnosis, was told locally that he had six months to get his affairs in order and to make the best of the time he had left. As fate would have it, he ended up in my clinic a month later for a second opinion. Frank was a retired sheriff, and he had kept himself in shape over the years. He ultimately ended up going through an unrelated donor transplant.

Frank was among those people you only meet once in a lifetime. He was a big man and his 6-foot-plus frame was well suited for his career in law enforcement. He also had a big heart – his visits to the clinic would brighten up the dreariest of Cleveland days. He treated everyone like family. We would give him a buffer of a few hours before his visit with me, since he would talk to and hug everyone on the way to our clinic, starting with the parking valet. He knew everyone at our BMT Program, and everyone knew him. Frank passed away last year, nearly five years after his transplant.  

Whether it was coincidence or providence, I don’t know – but his wife texted a photo of Frank and me along with a thank you note as I was in the midst of collecting my thoughts for this blog. I called her right away, and we spoke about Frank. She shared all the things Frank wanted to do and did do since his transplant – the graduations, the grandchildren, the travel, and the mundane such as mowing the lawn that was so important to him. She talked about his final days, and we reminisced about his last visit with me, which Frank ended with a hug and “Thank you doc, God bless!” in his signature Kentucky drawl.

We all have our success stories. We all have patients who did not do well. But Frank reminds me that irrespective of outcomes, what we do every day is very special. And we need to keep pushing the envelope for our field – and this is the passion that drives the ASTCT and our leadership.

Thank you again! Looking forward to seeing many of you at the TCT meeting in Orlando.

Tags: presidents message, TCT Meetings 2020, navneet majhail

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