It’s a pleasure for me just to be here with Professor Hoelzer, which was one of my let’s say, heroes of my young career as a hematologist. It was my pleasure today also, to give him an award for his career since he has been a leader, is even now, a leader in the field of acute lymphoblastic leukemia. And I would like Dieter just to say, a few words in how this disease has progressed over the years in children and afterwards, also in adult ALL.

First of all, I was really surprised to get such a nice award. Didn’t expect it anyway, It’s very kind.

So we were good at hiding..

So just a short history, my work was acute lymphoblastic leukemia started about 50 years ago, and after finishing to study, I worked in a children’s hospital, and nearly all the children at that time with leukemia died. So it was the same time when the stem cells came up and there was a famous young professor and I went to him and saying, my guess is acute lymphoblastic leukemia has to do something with the normal stem cells to transfer them or translate them. So I started six years working, not really with patients, but with the animal model. But then I became really interested in acute lymphoblastic leukemia. And then in Germany, there was a big program starting. So after this six years research, I found the study group for acute lymphoblastic leukemia, which has now, I think, 140 hospitals. Sometimes I am a little bit suspicious how I convinced the people. Anyway, we are working together. And, at that time, the cure rate for adult ALL was 8% at three years, because, the elderly professors at that time, they said, oh, no, it’s not so worse. But then three young doctors went to different so called famous hospitals, and finally, it turned out it was 8%. And then everybody agreed that there is some research necessary. The government spent money. And I started with this acute lymphoblastic leukemia working group, as you know, and, which is growing and did a lot of studies in the meantime.

Good. And nowadays we are in a moment in which, also for adult ALL, we can realistically speak about 60% of survival at five years, so it’s really a good good improvement. So in your opinion, just to make this 60% 80% which is our next goal.. I have to say, When I started, I had a diagram showing the cure rates, and there was a peak up – these were the children’s. When the Pinkel introduced CNS irradiation to eradicate the resting leukemic cells in the brain and, the adults, we are just behind it. But then I think we could really learn from the pediatricians what to do. And there was a steep increase, and I always said, I’ll stop my work if 50% of adults are cured, but-

You cannot stop, even if

that goal is achieved, then I saw the curve and said, no, you have to continue, and now we are in the average by 60%. But you know, we have sub groups with 90% Burkitt, 90% cure rate and some others, which is a great achievement. But we still have a lot to do, particularly for the elderly, and I think the the great change is really that we have now not only chemotherapy, I must say. I was at a certain point. I was frustrated to further intensify the chemo, and you could see you just increase the toxicity. And the cure rate is stable. But with the tyrosine kinase inhibitors and now with the immunotherapy, with the biological approaches, it’s a great move. It’s a great move to avoid toxicity to increase the cure rate, as you said in the average 60%. But we have better subgroups, and we have still a lot of things to do.

I think we still transplant a lot of patients, and, it’s a curative therapy. But you have also a lot of toxicity, long-term.. so It’s both better cure rate and improvement of life quality, and I think the biological therapy is a very good way to achieve that.

Also, maybe we are lucky enough again. Just identification of novels groups like, for example, the Ph-like ALL in which we understood, and hopefully we’ll confirm our hypothesis that even in this case, targeted therapies might improve further their outcome.

Absolutely agree.

So now it’s Ph-like ALL next future, maybe there will be some other groups in which we can do something else. Something more targeted, less toxic.

But you know, I’m always interested also in the whole group because we have to be aware we are living in rich countries. We can do all the diagnostics. We have the availability of normal… drugs, and it’s good that we have to be the pioneers. But on the other hand, we have to also look for therapies which are applicable in many countries in the world, you know, and affordable and tolerable.

This has been mentioned before, also by Professor Foa, because indeed you’re right.

We are fortunate countries. If you look at our colleagues from the United States, they may be even more fortunate, at least if they have insurance. But there are others.

They have everything, but I think they have equal cure rates. But there are a lot of countries around the world. And like Robin, I go to several countries and, I mean there you have to start with very simple things. And what I noticed, one is to work together. I mean, you go to a city, a country they have three big cities, three big universities, hospitals. They don’t work together. They don’t exchange, they have a director, and the director is saying, What’s going on? So what is now common in most Western European countries and the United States that you communicate. It’s new, and I think this is the key to improve the results, to work together and, psychologically, you have to also find rewards. So one is doing the diagnostics. The next one is the clinics, the transplant, to keep the motivation. I think it’s very important to keep the motivation in study groups and in the institutions participating in the study,

Thank you.