Introduction
The European Haematology Association (EHA) marked its 30th anniversary with a spectacular congress in Milan. EHA2025 was the largest event in the association's history, attracting a record number of 18,000 attendees. The redesigned and expanded scientific program featured over 130 speaker sessions and more than 4,000 abstracts, bringing together industry leaders from around the world.
Personal experience
As a Scientific Medical Liaison, I was particularly eager to connect with our customers and Key Opinion Leaders (KOLs) from around the world, and to delve into the latest scientific developments. EHA2025 exceeded all my expectations. Many attendees conveyed that the EHA congress is now rivals the ASH conference in size and scale.
Updated Multiple Myeloma clinical practice guideline
One standout session focused on the newly updated guidelines for Multiple Myeloma (MM) clinical practice. Echoing the ASH conference in 2024, the recommendations included urine-free response criteria in MM and the mandatory measurement of serum free light chain and serum immunoglobulin at diagnosis, response assessment, follow-up, and relapse. These updates are crucial for improving patient outcomes.
Tool |
Diagnosis |
At response |
At follow-up |
At relapse |
Blood tests |
||||
Blood count and blood smear |
Obl | Obl | Obl | Obl |
Serum electrophoresis and immunofixation |
Obl | Obl | Obl | Obl |
Serum free light chain |
Obl | Obl to confirm sCR | Obl | Obl |
Serum immunoglobulin levels |
Obl | Obl | Obl | Obl |
Renal and liver function tests |
Obl | Obl | Obl | Obl |
Calcium |
Obl | Obl | Obl | Obl |
Lactate dehydrogenase |
Obl | Obl | Obl | Obl |
Albumin, β2 microglobulin |
Obl | NR | Opt | Obl |
Flow cytometry |
Opt | NR | NR | Opt |
| Urine tests | ||||
| Urine sample from 24-h urine collection to check for proteinuria and serum free light chain proteinuria | Obl | NR | NR | Obl |
| Urine electrophoresis and immunofixation | Obl | Obl | NR | Obl |
| Bone marrow assessments | ||||
| Bone marrow cytology and biopsy to confirm plasmacytosis and monoclonality | Obl |
Obl to confirm CR or fornon-secretory MM | NR | Opt (obl for non-secretory MM) |
NGF or NGS to detect clonal plasma cells |
Obl |
Obl to confirm MRDnegativity in patients wit CR or sCR | Every 12 months in MRD-negative patients | Opt |
| Cytogenetics: karyotype and FISH for detection of del17p, t(4;14), t(14;16), t (14;20), 1q gain or amplification, del1p32 and t(11;14), and NGS for TP53 mutations | Obl |
NR |
NR |
Obl in patients with del17p, del1p32, 1q gain or amplification and TP53 mutations |
Advanced techniques: GEP, NGS |
Only in clinical trials | Only in clinical trials | Only in clinical trials | Only in clinical trials |
| Imaging | ||||
PET–CT or DWI MRI |
Obl |
Obl to confirm imaging MRD | Every 12 months in MRD-negative patients | Obl (also for detection of paramedullary or extramedullary disease) |
WBLD CT |
Obl (if PET–CT or DWI MRI NA) |
NR |
When symptomatic (or CT of the symptomatic area) |
Obl (if PET–CT or DWI MRI NA) |
CR, complete response; DWI, diffusion-weighted imaging; FISH, fluorescence in situ hybridization; GEP, gene expression profiling; MM, multiple myeloma; MRD, minimal residual disease; NA, not available; NGF, next-generation flow cytometry; NGS, next-generation sequencing; NR, not required; Obl, obligatory; Opt, optional; sCR, stringent complete response; WBLD, whole-body low-dose.
Adapted from Dimopoulos, M.A., Terpos, E., Boccadoro, M. et al. EHA–EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma. Nat Rev Clin Oncol 22, 680–700 (2025).
Defining high-risk Multiple Myeloma
The IMS-IMWG consensus recommendations on high-risk Multiple Myeloma were another highlight of EHA2025. Despite the lack of an official standard definition, high-risk MM is associated with significantly poorer survival outcomes, necessitating risk-adapted treatments. The session emphasized the need for a consolidated definition that includes functional aspects, age/frailty, imaging abnormalities, tumour burden, and newly identified genetics.
Reference: Avet-Loiseau H et al. Journal of Clinical Oncology. 2025 (link)
Hidden Light Chain Amyloidosis in Myeloma clinics
In a compelling session, Dr. Meuleman, Dr. Palladini and Dr. Wechalekar highlighted that patients with Light Chain Amyloidosis (AL) might already be present in myeloma clinics. MM patients are at a higher risk of developing AL, with up to 30% of AL amyloidosis patients being asymptomatic and thus ‘hidden’. Patients can develop both diseases sequentially. Haematologists are best place to find these patients amongst their MM clinics. Early diagnosis is critical to prevent irreversible organ damage as the impact of AL amyloidosis on patients’ survival is drastic. All clinical cases showed an increase in serum free light chain (sFLC) preceding the AL presentation. The session concluded with the powerful message: “Not as rare as you think.”
Infection risk in focus
EHA2025 also shed light on managing infections risk in myeloma patients. Patients with hematologic malignancies are at an increased risk of infections, due to disease-related immune dysfunction and the effects of therapies compromising immunity. Therapies such as anti-CD38 monoclonal antibodies, bispecific antibodies, and BCMA-CAR T-cells are described to significantly compromise the patient’s immune function and induce secondary immune deficiencies. Practical guidance was provided to support clinical decision-making, including the use of IGRT to reduce infection risk in MM patients.
A clinician, a patient and a nurse…
In an engaging interview-style session, Prof. Joseph Mikhael and his guest speakers discussed their approach to managing relapsed/refractory Multiple Myeloma with a focus on Shared Decision Making. The session featured:
- A clinician’s perspective on charting the course of R/R MM management, with Rakesh Popat.
- A patient’s perspective on living with MM, with Dr. Eididh Duncan.
- A nurse’s perspective on anchoring patient care in the MM Journey, with Jackie Quinn.
A memorable quote from this joint session by MPE and Medscape was: 'The good physician treats the disease; the great physician treats the person who has the disease'.
Binding Site conclusion
EHA2025 was an extraordinary event that not only celebrated three decades of progress in haematology but also set the stage for future innovations. The congress provided invaluable insights, fostered meaningful connections, and highlighted the importance of collaboration. As we move forward, the knowledge and relationships gained at EHA2025 will undoubtedly drive our efforts to improve outcomes for patients worldwide. I am eager to apply these learnings and continue engaging with the vibrant haematology community.