It was a long journey and an early morning. Sure, some people have travelled further and probably got up earlier but, sat writing this, I feel the pain. It was good to finally arrive in Serbia for CML Horizons 2014, no thanks to Air France who tried to derail me at every step. 

I was sad to have missed the opening video from Dr. Brian Drucker and the tribute to John Goldman, that pesky journey has much to answer for. I look forward to seeing the video and tribute on the CML Advocates website. So, things kicked off with a trip around the world with advocacy sessions: Latin America, Africa & Middle East, Asia-Pacific, North America and  Europe. This whistle-stop tour featured a key delegate from each region who presented an overview and the main challenges they faced. I was particularly struck, from Greg Stephens’ presentation, by the huge increase in CML deaths in North America. Whilst Greg is working on trying to understand what is causing this disastrous trend, I’d take a bet on it coming down to finance. The same old story. Very disappointing. It’s even more disappointing coming on the back of the excellent Leukaemia & Lymphoma Research, Impact Day, in London where we heard about the fantastic progress being made in the world of blood cancer.

Jan Geissler did his best to redress the balance with a more healthy European outlook but as we move West to East across Europe the challenges become greater. More disparity. All of the regions are working hard to bring a fair distribution of drugs that ultimately save lives. 

To the first medical session of the conference; Dr Neil Shah updated the delegates with the latest available treatments. Whilst we touched upon various forms of treatment including stem cell transplants and interferon-alpha the focus was on TKIs. The long term IRIS trial (7-8 year follow up), which is sadly coming to an end, shows a 93% survival rate considering only CML deaths for patients on Imatinib. Dr Shah felt that Imatinib has outperformed all expectations. We were presented with data that shows nilotinib and dasatinib as superior treatments to imatinib. For example in trails the complete cytogenetic response rate by 12 months on dasatinib is 83%, for imatinib 72%. For major molecular remission rate by 48 months, 76% on nilotinib and 58% on imatinib. This isn’t to say that imatinib isn’t the wonder drug it was first heralded as, without it this stunning progress could never have been made; and for those patients it suits, it works incredibly well. 

Next up, a fascinating update on therapy recommendations from Prof Giuseppe Saglio from the University of Turin, who really drilled the data down for us and showed a very logical progression of drugs and optimum responses. It is very clear that new drugs have given our clinicians excellent ammunition in the treatment of CML.

Finally, Dr Qian Jiang from the Peking University People’s Hospital who spoke about the role of transplant in CML. Whilst it is still a very important part of treating CML, the number of operations has steeply declined since the advent of TKIs. It is however, fascinating to see continuous development and improvement in this key area.

After a short question and answer session the day broke and we all raced back to our rooms to prepare for dinner. It was wonderful to catch up with old friends and see many new faces. Most conversations started, “has it really been a year?”. 

The CML community is lucky to have such a vibrant, resilient and informed group of people. With hard work and good bonds the group have take an orphan disease and put it firmly on the blood cancer map. Better than that, they have shown the way. The group is keen to talk about ‘advocacy’ and ‘blood cancer’ rather than isolate itself by being singular. This is the key, the group understands that the progress being made here and now will affect cancers of all types for generations to come.

Today has really set the pace for a fantastic conference. Stay tuned…same CML time….same CML channel.