Author:

Franco Cavalli

For over 20 years, the International Conference on Malignant Lymphoma (ICML) has established itself as a leading global event in the field of malignant lymphomas. Its origins, however, were quite serendipitous.

In 1979, I organized a closed workshop in Lugano for the International Union Against Cancer (UICC), focusing on "New Approaches to Testicular Cancers." At the time, the breakthrough treatment with Cisplatin was transforming outcomes for non-seminomatous testicular cancers, while retrospective studies were beginning to suggest that stage I and possibly stage II seminomas could be managed with conservative approaches, using only surgery. The workshop, which gathered around 50 participants under the leadership of Mike Peckham from the Royal Marsden Hospital in London, was a resounding success. Afterward, I found myself sitting by Lake Lugano with two close friends, Gianni Bonadonna from the Istituto Nazionale dei Tumori in Milan and Marcel Rosenzweig from the Institute Jules Bordet in Brussels (later Vice-President at Bristol Myers). Both were so taken by the location that they suggested hosting a larger event in Lugano. After some discussion, and a few beers, we identified malignant lymphomas as a field in need of a major congress and committed to making it happen as soon as possible.

The following week, I reserved 500 hotel rooms in Lugano for September 1981 and organized a visit to leading American cancer centers such as Dana-Farber, Memorial Sloan Kettering, and MD Anderson, meeting experts like Henry Kaplan at Stanford and John Ultmann in Chicago, who were then leading figures in Hodgkin disease treatment. Both had a personal connection to Lugano, as they had awaited visas there in 1933 before emigrating to the United States. Kaplan and Ultmann enthusiastically supported the idea of an international lymphoma conference in Lugano and committed to helping secure the participation of American onco-hematologists. From the start, we aimed to set a high standard for the quality of presentations, which I believe has been a key to ICML's remarkable success.

In September 1981, approximately 500 physicians and researchers gathered in Lugano for the inaugural ICML, with Vincent DeVita, then NCI Director, delivering the keynote address. At the time, our understanding of lymphomas was limited; it was unclear whether Hodgkin disease was a form of lymphoma or an infectious condition, with some comparing it to certain subtypes of tuberculosis. This debate had continued since Sir Hodgkin first described the disease in 1832. In 1993, however, at an ICML conference, Professor Küppers presented compelling evidence that Hodgkin disease was a B-cell neoplasia, leading to its reclassification as Hodgkin lymphoma.

Organizing that first conference was a simple, family-centered effort: my father managed finances, my brother printed materials at his print shop, and my wife and children helped mail the invitations. Since then, ICML has grown tremendously; it now attracts around 4,500 participants, the logistical maximum for the Lugano area, though many more now join online via live streams. Originally a 2.5-day event, it has expanded to five days, with the first day dedicated to a closed workshop and various satellite symposia. To honor the founders of ICML, the conference features three major keynote lectures: the Henry Kaplan lecture (accompanied by a major prize from the San Salvatore Foundation), the Gianni Bonadonna lecture, and the John Ultmann lecture. These talks are selected by the Scientific Advisory Board (SAB), which includes prominent lymphoma specialists from around the world and is integral in shaping the scientific program.

Each ICML receives between 800 and 1,000 abstract submissions (in 2023: 24% from US, 17% from China 8% from France and so on) , of which only 12-13% are selected for oral presentations—making it one of the most selective conferences in the field. Roughly 30% of abstracts are presented in poster sessions. Held every three years until 2011, ICML has since moved to a biennial schedule, with the 18th edition set for June 17-22, 2025.

A defining feature of ICML since 1990 is its closed workshop held the day before the main conference. This session, attended by 50-70 global experts, tackles the most pressing topic in the field. Often, these discussions lead to collaborative studies or evaluations to address unresolved issues. For instance, in 1990, we addressed prognostic factors in large B-cell lymphomas, a topic that led to the development of the International Prognostic Index (IPI), now a standard clinical tool for diffuse large B-cell lymphomas. Many such workshops have driven advances in lymphoma research and treatment, resulting in numerous publications, including studies on GI-lymphoma classification, CNS lymphoma research methodologies, REAL classification validation, liquid biopsy roles, genetic analysis in follicular lymphoma, and the widely-used Lugano classification for staging and restaging malignant lymphomas.

In recent years, ICML has expanded its educational offerings, including Meet-the-Professor sessions, large multidisciplinary educational symposia, multidisciplinary discussions of difficult cases and innovative special sessions. Recent highlights include a session on canine lymphomas in 2019, special symposia for radiation oncologists in 2021 and 2023, and a session organized by clinical nurse lymphoma specialists planned for 2025. Since 2019, ICML has also partnered with the Chinese Union of Lymphoma Researchers (UCLI) to host a dedicated session.