Evaluation and Treatment of Complement-Mediated Blood Disorders in Women of Childbearing Age

This satellite symposium took place preceding the 60th American Society of Hematology (ASH) Annual Meeting and Exposition on November 30, 2018, in San Diego, CA.  

This symposium brings together leading experts in the field to review the complement physiology with an emphasis on the intersection of complement, coagulation, and diseases affecting women of reproductive age. The complement system is an under-appreciated pathogenic mechanism for thrombotic and inflammatory disorders, with significant cross-talk between complement, coagulation, and fibrinolytic systems. Several hematological diseases including hemolytic uremic syndrome (HUS), paroxysmal nocturnal hemoglobinuria (PNH), antiphospholipid syndrome (APS), HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelet count) syndrome and even thrombotic thrombocytopenic purpura (TTP) are or may be, complement-mediated diseases. Given the rarity of these syndromes, hematologists, and obstetricians, alike, have a limited understanding of complement’s role in these diseases or emerging therapies directed at complement pathways. The faculty will provide a comprehensive review of these topics, as well as current diagnostic and treatment strategies that can lead to improved care for women of childbearing age, and then will address issues and questions from the audience.

This session was jointly provided by Cine Med and the Foundation for Women & Girls with Blood Disorders. 

Learning Objectives and Goals:
At the concussion of this symposium, participants should be able to:

• Describe components of complement and complement regulatory protein
• Identify the role of complement in the thrombotic spectrum of disorders
• Recognize and manage the range of complications related to uncontrolled complement activation in pregnant women with HUS 
• Recognize the role of anticoagulation during pregnancy and the postpartum period in women with PNH 
• Appropriately apply complement inhibitory therapy during pregnancy and the postpartum period in women with PNH
• Explain the diagnostic challenges due to the heterogeneous population of antibodies in APS
• Discuss the clinical maternal and fetal significance of HELLP syndrome through the eyes of obstetrics and hematology
• Explain HELLP syndrome in the context of the genetics of the alternative complement pathway (ACP)
• Recognize the potential of complement inhibition to reduce early pre-term birth
• Demonstrate and apply current treatment approaches to complement-mediated diseases for women of childbearing age 

Welcome

Presented by  Andra H. James, MD, MPH (Activity Director)

Session Two: Cross Talk: Thrombosis and the Complement Pathway

Presented by Gowthami Arepally, MD (Program Chair and Moderator)

Session Three: Overview of the Complement Pathwa

Presented by Sanjay Khandelwal, PhD

Session Four: HELLP Syndrome, Complement Regulation and Pregnancy

Presented by Arthur Jason Vaught, MD 

Session Five: Hemolytic Uremic Syndrome (HUS) in Childbearing Age Women

Presented by Carla Nester, MD, MSA

Session Six: Management of PNH During Pregnancy and the Postpartum Period

Presented by Charles Parker, MD 

Session Seven: Antiphospholipid Antibodies: Is APS a Complement-Mediated Autoimmune Disorder?

Presented by Ware Branch, MD 

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