On May 14^th and 15^th we had the pleasure of hosting at our Center in Rome 18 hematologists, from different cities of the Turkish Republic, to attend the course: “Challenges in CLL today”. The purpose was to underline and discuss the remarkable changes that have occurred in this disease – which represents the most frequent leukemia in the western hemisphere – over the last decade. This has led to progressive and impressive advancements in our knowledge of the biology of CLL and, in turn, to profound changes in the management of patients suffering from this disease.

The group of the Turkish colleagues was accompanied by Prof. Mehmet Ali Ozcan, from the Izmir “9 Eylul” University. Throughout the two-day course, several aspects of CLL, such as a correct diagnostic classification, a precise differential diagnosis with other related conditions, the role and impact of a biologically-based prognostic stratifications and the relevance of such markers in the clinical management were actively discussed. Important issues, such as epidemiology, life expectancies, quality of life, etc were also covered. The second day was dedicated to the treatment of patients with CLL, from ‘conventional’ treatment to innovative approaches. The broad therapeutic armamentarium available and the different treatment options nowadays possible, including allogeneic and autologous hematopoietic stem cell transplant procedures, were discussed. Attention was paid also to the overall management currently ongoing in Turkey. All the above were achieved through oral lessons, interactive discussions and clinical case presentations prepared both by the Faculty and by our Turkish colleagues.

Each day, two hours were dedicated to a practical session. The participants, divided in 3 small groups, had the opportunity of visiting the different laboratories in function at the Hematology Center in Rome. These included in particular the flow cytometry laboratory and the molecular genetics laboratories, with a special focus on the new array-based technologies (gene profiling, p53 sequencing, etc). Particular emphasis was given to show on practical grounds what the laboratories can offer today in support to the clinicians in terms of diagnosis, prognosis and monitoring of minimal residual disease, as well as in terms of an always growing understanding of the biology of CLL. The close interaction between the clinic and the laboratories for an optimal management of patients with CLL was repeatedly underlined.

Finally, specific clinical scenarios, such as spontaneous regressions of CLL and monoclonal B-cell lymphocytosis, were presented and discussed as further examples of the ‘unicity’ of this disease.

All participants underlined the very warm and interactive atmosphere between all participants.

The close relationship with Turkish hematologists and with the Turkish Society of Hematology is further documented by the EHA-ESH Tutorial on “Lymphoid Malignancies” that took place in Kayseri in September 2009 and by the forthcoming Tutorial on “Myeloid Malignancies” that will be held in Istanbul on June 25-27, 2010, as well as on other joint activities that are in the pipeline.

Robin Foà

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