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Vascular Anomalies, Vascular Malformations, and the Role of the Hematologist

Program: Education Program
Hematology Disease Topics & Pathways:
Bleeding and Clotting, Clinical Practice (Health Services and Quality), Diseases, Treatment Considerations
Monday, December 9, 2024: 4:30 PM-5:45 PM
Room 25 (San Diego Convention Center)

Description:
Vascular anomalies have traditionally been managed by surgical and interventional radiology colleagues. However, an evolving understanding of the pathophysiology, genetic landscape and hematologic outcomes will necessitate involvement from hematologists and oncologists for comprehensive care. This session will explore the molecular underpinnings and genetic factors of these conditions, highlighting the shift towards targeted medical therapies informed by recent discoveries in crucial signaling pathways. The talks will also cover the management of hemostasis and thrombosis risks, stressing the need for a multidisciplinary approach to diagnostics and treatment to enhance patient safety and outcomes. Together, these talks will shed light on the latest scientific advancements and their translation into clinical practices highlighting the pivotal role hematologists and oncologists play in this specialized care.

Dr. Vikkula will present an overview of the current understanding of the pathophysiological foundations of vascular anomalies. He will examine how genetic associations across various clinical cases inform the diagnostic work-up and classification of these conditions. Additionally, he will discuss the pathophysiological effects of the characterized pathogenic variants, which underlie the basis of developing targeted medical therapies for vascular anomalies.

Dr. Borst’s talk will review currently available medical therapies for vascular anomalies, review guidelines for drug dosing and monitoring, and introduce some novel therapeutics. The discovery of somatic pathogenic variants in the PI3K/AKT/mTOR and Ras/MAPK intracellular signaling pathways as drivers of vascular anomalies has led to a new era of precision medicine for these malformations and tumors. Hematologists/oncologists are critical to the care of patients with vascular anomalies, owing to expertise in managing targeted medical therapies.

Dr. Crary’s talk will focus on the evolving role of hematologists in diagnosing and managing consumptive coagulopathy associated with vascular anomalies such as kaposiform hemangioendothelioma and slow-flow vascular malformations She will emphasize the importance of interdisciplinary approaches, especially in peri-operative settings, to prevent complications like bleeding and venous thromboembolism. The talk illustrates the use of clinical signs, imaging, laboratory findings, and anticoagulation therapy to improve patient outcomes.

Chair:
Shelley E Crary, MD, MS, ARRAY(0xe7bbd90)
Disclosures:
Crary: Novartis: Consultancy; ASC Therapeutics: Consultancy; Sanofi: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Medexus: Membership on an entity's Board of Directors or advisory committees; CSL Behring: Membership on an entity's Board of Directors or advisory committees.

Vascular anomalies have traditionally been managed by surgical and interventional radiology colleagues. However, an evolving understanding of the pathophysiology, genetic landscape and hematologic outcomes will necessitate involvement from hematologists and oncologists for comprehensive care. This session will explore the molecular underpinnings and genetic factors of these conditions, highlighting the shift towards targeted medical therapies informed by recent discoveries in crucial signaling pathways. The talks will also cover the management of hemostasis and thrombosis risks, stressing the need for a multidisciplinary approach to diagnostics and treatment to enhance patient safety and outcomes. Together, these talks will shed light on the latest scientific advancements and their translation into clinical practices highlighting the pivotal role hematologists and oncologists play in this specialized care.

Dr. Vikkula will present an overview of the current understanding of the pathophysiological foundations of vascular anomalies. He will examine how genetic associations across various clinical cases inform the diagnostic work-up and classification of these conditions. Additionally, he will discuss the pathophysiological effects of the characterized pathogenic variants, which underlie the basis of developing targeted medical therapies for vascular anomalies.

Dr. Borst’s talk will review currently available medical therapies for vascular anomalies, review guidelines for drug dosing and monitoring, and introduce some novel therapeutics. The discovery of somatic pathogenic variants in the PI3K/AKT/mTOR and Ras/MAPK intracellular signaling pathways as drivers of vascular anomalies has led to a new era of precision medicine for these malformations and tumors. Hematologists/oncologists are critical to the care of patients with vascular anomalies, owing to expertise in managing targeted medical therapies.

Dr. Crary’s talk will focus on the evolving role of hematologists in diagnosing and managing consumptive coagulopathy associated with vascular anomalies such as kaposiform hemangioendothelioma and slow-flow vascular malformations She will emphasize the importance of interdisciplinary approaches, especially in peri-operative settings, to prevent complications like bleeding and venous thromboembolism. The talk illustrates the use of clinical signs, imaging, laboratory findings, and anticoagulation therapy to improve patient outcomes.

Miikka Vikkula, MD, PhD

De Duve Institute, Universite Catholique De Louvain, Brussels, Belgium

Alexandra Jane Borst, MD

Pediatric Hematology-Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, NC

Shelley E Crary, MD, MS

Arkansas Children's Hospital, Little Rock, AR

See more of: Education Program