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“When Sorrows Come, They Come Not Single Spies…”

December 11, 2021
Tania Jain, MBBS

Dr. Tania Jain (@TaniaJain11) is an assistant professor and director of the Adult CAR T Program at Johns Hopkins University. Her academic interest is in cellular therapy, bone marrow transplantation, and myeloproliferative neoplasms including overlap with myelodysplastic syndromes. She is a graduate of Government Medical College, Patiala (Punjab), India, where she received her medical degree, before going on to a residency at Wayne State University/ Detroit Medical Center, and fellowships at Mayo Clinic in Arizona and at Memorial Sloan Kettering Cancer Center for bone marrow transplantation. 

Dr. Jain grew up in Chandigarh, India, and has since been, in her words, “nomadic … our current residence in Baltimore is what we call home now.” She is a longtime enthusiastic attendee of the ASH annual meeting since second year of fellowship (no breaks) as well as speaker at Highlights of ASH® in North America in 2020. Prior to travel restrictions, Dr. Jain enjoys chipping away at some very specific and ambitious travel goals with her husband. “Our travel adventures of late revolved around visiting the four (north, south, east, and west) extreme points of the United States. We have thus far been to Point Barrow in Alaska (northernmost), Point Buoy in Key West, Florida (southernmost for the continental United States), and almost to (less than 10 miles away from) Ka Lae (South Cape) in Hawaii, which is southernmost for the US overall,” she explained. “This got interrupted with COVID, but we are excited to get back to our travel adventures.” Fingers crossed, and happy trails, Dr. Jain! 

It has been almost two years since the pandemic started, and COVID-19 remains a part of everyday conversation. At some point during this COVID-19 frenzy, my 90-year-old grandmother said, “I have never seen anything like this in all my life. This is going to make us all dance to its tune…” Her words remain true and, to our despair, may ring true for a while. Damage of more than one kind was imminent then and, although to a lesser degree, continues to loom 20 months later. 

Immunothrombosis was one of the many adversaries that hit us with the emergence of COVID-19. While we might have recognized these events relatively early during the pandemic, we remained challenged for a while in understanding the mechanisms and strategies used to tame it. The Education Program session “The COVID Crash: Lessons Learned from a World on Pause” (with virtual and in-person live Q&A on December 11) aims to address the nuts and bolts of this intriguing paradox of coagulopathy and bleeding. Chaired by Dr. Shruti Chaturvedi, talks will cover the risks, pathogenesis, contribution to COVID-19 associated morbidity and measures to prevent and treat these complications. With the vaccine came a glimmer of hope that was quickly tarnished by vaccine-induced immune thrombotic thrombocytopenia (VITT; also known as thrombosis with thrombocytopenia syndrome). This relatively low-incidence complication knocked at our doors unwelcomed, and arguably diminished enthusiasm while possibly also scaling back implementation. We have all had myriad discussions amongst ourselves and with our patients, friends, and family about what VITT means and how to respond to this less known new impediment. Whether this is an inflammatory response, or a response to the adenovirus vector or the impurities in the vaccine, or any of the many other questions surrounding VITT, this session will address many-a-question on coagulation from COVID-19 infection and vaccination.  

While COVID-19 brought the world to a pause, it also brought all hands on the deck from an infinite community of researchers to address the innumerable questions that arose during this period. Clinical trials were conducted and completed at record pace. This session will highlight  the recently completed multiplatform randomized controlled trials, such as HEP-COVID and RAPID, that led clinicians to reassess their approach to prophylactic anticoagulation in COVID-19. As a potential attendee, I can expect to be enlightened about these trials and the current best practices in managing COVID-19–associated coagulopathy and bleeding. This unwavering effort from health care research teams across the globe led to the development of vaccines for the prevention of COVID-19 as well as promising options for treatment, including convalescent plasma and monoclonal proteins, all of which will be covered at this session — the good, the best, and the ugly — all of it!  

As some of us prepare to attend this year’s ASH annual meeting in-person and others virtually, and as we welcome another holiday season of perpetual hope, we have a lot to be thankful for. Life has started to move on after a 20-month pause, not without bumps albeit, and we have marched forward with indomitable resilience in the face of this misfortune. This session will review what we have learnt, ought to remember, and dare not forget! As I prepare to attend, I am making note of all COVID-related questions that I want to ask these experts because, admittedly, I still find myself lost at sea too often in the COVID-19 world. 

For folks who can relate to this state of COVID-induced perplexity, there are other sessions at the meeting that will cover COVID-related nuances around acute myeloid leukemia (“Acute Myeloid Leukemia: Clinical and Epidemiological: COVID and Beyond” on Saturday, December 11, in-person and virtual), myeloproliferative neoplasms (“Myeloproliferative Syndromes: Clinical and Epidemiological: Transplantation, COVID-19, and Biology Insights” also on Saturday, in-person and virtual), and immunocompromised patients (“Scientific Symposia on COVID-19 Vaccination in Immunocompromised Patients” with virtual and in-person live Q&A, on Sunday, December 12). Additionally, Monday’s virtual and in-person Special-Interest Session “ASH Advances COVID Research 2021” will provide additional information on thrombosis in the setting of COVID-19, outcomes of COVID-19 infection in hematology patients, and immunology and immune response to COVID-19 vaccines. So get all your questions together and mark your calendars! 

Dr. Jain indicated no relevant conflicts of interest. 

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