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EBMT 2020 Annual Meeting - Steroids - The haematology bad boys


Nurses Education Day - Saturday 29 August, 13:30-14:30H & 15:00-16:00H, Auditorium 2

In the first of the Nurses Group sessions at this year’s online EBMT congress, the speakers will address steroids, their major indications and side effects, and how we cannot live with or without them.

Nurses Group President John Murray (Christie Hospital NHS Foundation Trust, Manchester, UK) explains: “Each year the Nurses Group chooses a topic or a theme for our stand-alone Nurses Education Day. The meeting this year has now had to transform from face-to-face onto the digital platform due to the COVID-19 outbreak. As a consequence, we have had to shorten the Education Day, but we still have some fantastic presentations prepared and delivered by our glittering faculty.”

He says: “Steroids are an integral part of haematology and are used in a wide variety of indications, from diagnosis and early treatment regimens all the way through to palliative and supportive care at the end of life. We truly cannot live without them, even though they are the so-called ‘bad boys of haematology’.”

One of the speakers in this session will be Jörg Halter of University Hospital Basel, Switzerland. He says: “The rationale why steroids are used for treatment of GvHD will be discussed, and when they should be started. Still many gaps in our knowledge exist, for example how to taper steroids, leading to highly variable exposure of patients to cumulative steroid doses.”

He will discuss that, although steroids control GvHD, in a considerable number of patients their effect is limited, hence there is an ongoing need for signals to start alternative or additional treatments that will need to be tested. “The mechanism of action and the most important side effects on bones, muscles and immunodeficiency will be addressed in separate talks,” he adds.

Pharmacist Agnès Bonnin, of the Haematology and Cell Therapy Department at Saint Antoine Hospital, Paris, France, will also present in this session. She explains: “The mechanism of action of steroids is complex and not yet fully understood. They have many pharmacological properties that can be used to treat a wide range of conditions, but that are also responsible for the many adverse effects of these drugs.”

Agnès will give a short introduction on the origin of steroids and their characteristics, and will explain how to choose a steroid depending on patient and disease characteristics.  Then, an overview of mechanism of action will highlight why steroids are irreplaceable both for supportive care and specific treatment of some haematological malignancies, whereas they are not efficient or even should be avoided in other situations.

She says: “This presentation will provide some guidance on how to manage treatment and mitigate some of the adverse effects that are unfortunately inevitable with steroids.”

John concludes: “I invite you along to learn about the indications, mechanisms of action and the many side effects that our patients deal with on a day-to-day basis. We can certainly all learn something today to take back to our own centre and share with colleagues.”