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Gould C, McBean M, Thompson E, Lickiss J, Tiong IS, Westerman D, Blombery P. Observations from a national sample exchange program for molecular haematology testing. Pathology 2024; 56:540-547. [PMID: 38413254 DOI: 10.1016/j.pathol.2023.12.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/27/2023] [Accepted: 12/07/2023] [Indexed: 02/29/2024]
Abstract
External quality assessment programs (EQAP) for molecular haematology generally only assess the analytical phase of laboratory testing or provide limited evaluation of post-analytical components. We incorporated comprehensive post-analytical evaluation into an existing national inter-laboratory sample exchange program for molecular haematology due to the increasing complexity of diagnostic molecular testing and interpretation. We report key findings from four years of longitudinal data using this approach. Eighteen participating laboratories enrolled in an annual reciprocal sample exchange program from 2019-2022, which covered conventional and next-generation sequencing (NGS) assays. Participants submitted results on their laboratory information system-generated reports which then underwent central review. Reports were assessed according to consensus values and relevant national and international reporting standards and guidelines. A total of 680 reports were received. Laboratories had high concordance in the analytical phase of testing, with incorrect variant detection observed in a total of six of 680 (0.9%) reports. In contrast, post-analytical concordance was much lower, with at least one discordance observed in 28.9-57.6% of all conventional reports and 33.3-100% NGS reports. The most frequent post-analytical discordances were: (1) not including key technical information on reports (total 41.9% conventional, 47.2% NGS); (2) not using standard gene and variant nomenclature (total 28.2% conventional, 25.6% NGS). NGS reports also demonstrated discrepancies in variant classification (total 20.4%) and interpretation (total 10.2%). The rate of discrepancies generally improved year-on-year. Inter-laboratory concordance for molecular haematology testing is high in the analytical phase, however opportunities exist for improvement in the post-analytical phase. Given that result interpretation is crucial for clinical decision-making and that molecular testing is a complex and evolving field, we suggest that EQAPs should comprehensively evaluate both analytical and post-analytical components of laboratory performance in order to harmonise reporting and to support the accurate interpretation of molecular haematology tests.
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Affiliation(s)
- Clare Gould
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia.
| | - Michelle McBean
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia
| | - Ella Thompson
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia
| | - Jennifer Lickiss
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia
| | - Ing Soo Tiong
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia
| | - David Westerman
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Vic, Australia
| | - Piers Blombery
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Vic, Australia
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2
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Blombery P, Fox L, Ryland GL, Thompson ER, Lickiss J, McBean M, Yerneni S, Trainer A, Hughes D, Greenway A, Mechinaud F, Wood EM, Lieschke GJ, Szer J, Barbaro P, Roy J, Wight J, Lynch E, Martyn M, Gaff C, Ritchie D. Erratum to: Utility of clinical comprehensive genomic characterization for diagnostic categorization in patients presenting with hypocellular bone marrow failure syndromes. Haematologica 2024; 109:1311. [PMID: 38562077 PMCID: PMC10985447 DOI: 10.3324/haematol.2023.284760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 11/27/2023] [Indexed: 04/04/2024] Open
Affiliation(s)
| | - Lucy Fox
- Clinical Haematology, Peter MacCallum Cancer Centre
| | | | | | | | | | | | - Alison Trainer
- Clinical Haematology, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Peter MacCallum Cancer Centre
| | | | | | | | | | - Graham J Lieschke
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital
| | - Jeff Szer
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital
| | - Pasquale Barbaro
- Children Health Queensland and University of Queensland, South Brisbane
| | - John Roy
- Children Health Queensland and University of Queensland, South Brisbane
| | - Joel Wight
- Department of Haematology, Austin Health
| | - Elly Lynch
- Melbourne Genomics Health Alliance, Parkville
| | | | - Clara Gaff
- Melbourne Genomics Health Alliance, Parkville
| | - David Ritchie
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne, Australia
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3
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Loo S, Dillon R, Ivey A, Anstee NS, Othman J, Tiong IS, Potter N, Jovanovic J, Runglall M, Chong CC, Bajel A, Ritchie D, Gray K, Yeoh ZH, McBean M, Gilkes A, Thomas I, Johnson S, Russell NH, Wei AH. Pretransplant FLT3-ITD MRD assessed by high-sensitivity PCR-NGS determines posttransplant clinical outcome. Blood 2022; 140:2407-2411. [PMID: 35960851 PMCID: PMC10653044 DOI: 10.1182/blood.2022016567] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sun Loo
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
- Department of Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
- Department of Haematology, The Alfred Hospital, Melbourne, Australia
| | - Richard Dillon
- Guy’s and St Thomas Hospital, London, United Kingdom
- Department of Medical and Molecular Genetics, King’s College, London, United Kingdom
| | - Adam Ivey
- Department of Pathology, The Alfred Hospital, Melbourne, Australia
| | - Natasha S. Anstee
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
- Department of Haematology, The Alfred Hospital, Melbourne, Australia
| | - Jad Othman
- Guy’s and St Thomas Hospital, London, United Kingdom
- Department of Medical and Molecular Genetics, King’s College, London, United Kingdom
| | - Ing Soo Tiong
- Department of Haematology, The Alfred Hospital, Melbourne, Australia
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nicola Potter
- Department of Medical and Molecular Genetics, King’s College, London, United Kingdom
| | - Jelena Jovanovic
- Department of Medical and Molecular Genetics, King’s College, London, United Kingdom
| | - Manohursingh Runglall
- Department of Medical and Molecular Genetics, King’s College, London, United Kingdom
| | - Chyn Chua Chong
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
- Department of Haematology, The Alfred Hospital, Melbourne, Australia
| | - Ashish Bajel
- Department of Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
| | - David Ritchie
- Department of Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
| | - Kelli Gray
- Department of Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
| | - Zhi Han Yeoh
- Department of Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
| | - Michelle McBean
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Amanda Gilkes
- Division of Cancer and Genetics, Cardiff University, Cardiff, United Kingdom
| | - Ian Thomas
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Sean Johnson
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | | | - Andrew H. Wei
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
- Department of Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
- Department of Haematology, The Alfred Hospital, Melbourne, Australia
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4
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Singh J, Gorniak M, Grigoriadis G, Westerman D, McBean M, Venn N, Law T, Sutton R, Morgan S, Fleming S. Correlation between a 10-color flow cytometric measurable residual disease (MRD) analysis and molecular MRD in adult B-acute lymphoblastic leukemia. Cytometry B Clin Cytom 2022; 102:115-122. [PMID: 34806309 DOI: 10.1002/cyto.b.22043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/21/2021] [Accepted: 11/10/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Measurable residual disease (MRD) monitoring in acute lymphoblastic leukemia (ALL) is an important predictive factor for patient outcome and treatment intensification. Molecular monitoring, particularly with quantitative polymerase chain reaction (qPCR) to measure immunoglobin heavy or kappa chain (Ig) or T-cell receptor (TCR) gene rearrangements, offers high sensitivity but accessibility is limited by expertise, cost, and turnaround time. Flow cytometric assays are cheaper and more widely available, and sensitivity is improved with multi-parameter flow cytometry at eight or more colors. METHODS We developed a 10-color single tube flow cytometry assay. Samples were subject to bulk ammonium chloride lysis to maximize cell yields with a target of 1 × 106 events. Once normal maturation patterns were established, patient samples were analyzed in parallel to standard molecular monitoring. RESULTS Flow cytometry was performed on 114 samples. An informative immunophenotype was identifiable in all 22 patients who had a diagnostic sample. MRD analysis was performed on 87 samples. The median lower limits of detection and quantification were 0.004% (range 0.0005%-0.028%) and 0.01% (range 0.001%-0.07%) respectively. Sixty-five samples had concurrent molecular MRD testing, with good correlation (r = 0.83, p < 0.001). Results were concordant in 52 samples, and discordant in 13 samples, including one case where impending relapse was detected by flow cytometry but not Ig/TCR qPCR. CONCLUSIONS Our 10-color flow cytometric MRD assay provided adequate sensitivity and good correlation with molecular assays. This technique offers rapid and affordable testing in B-ALL patients, including cases where a suitable molecular assay cannot be developed or has reduced sensitivity.
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Affiliation(s)
- Jasmine Singh
- Laboratory Haematology, Alfred Pathology, Melbourne, Victoria, Australia
| | - Malgorzata Gorniak
- Laboratory Haematology, Alfred Pathology, Melbourne, Victoria, Australia
| | - George Grigoriadis
- Laboratory Haematology, Alfred Pathology, Melbourne, Victoria, Australia.,Clinical Haematology, Monash Health, Clayton, Victoria, Australia
| | - David Westerman
- Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michelle McBean
- Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Nicola Venn
- Children's Cancer Institute and School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Tamara Law
- Children's Cancer Institute and School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Rosemary Sutton
- Children's Cancer Institute and School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Sue Morgan
- Laboratory Haematology, Alfred Pathology, Melbourne, Victoria, Australia
| | - Shaun Fleming
- Laboratory Haematology, Alfred Pathology, Melbourne, Victoria, Australia.,Clinical Haematology, Monash Health, Clayton, Victoria, Australia
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5
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Kuzich JA, Kankanige Y, Guinto J, Ryland G, McBean M, Wong E, Koldej R, Collins J, Westerman D, Ritchie D, Blombery P. T cell receptor beta locus sequencing early post-allogeneic stem cell transplant identifies patients at risk of initial and recurrent cytomegalovirus infection. Bone Marrow Transplant 2021; 56:2582-2590. [PMID: 34031553 DOI: 10.1038/s41409-021-01354-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/29/2021] [Accepted: 05/10/2021] [Indexed: 11/09/2022]
Abstract
Identification of patients at risk of initial & recurrent cytomegalovirus (CMV) reactivation following allogeneic stem cell transplant (alloSCT) may help guide prophylactic strategies. T-cell receptor beta (TRB) deep sequencing was used to identify and enumerate the T-cell repertoire harbouring TRB sequences with annotated specificity to CMV (pubCMVrep), as well as the overall T-cell receptor (TCR) repertoire diversity at day +30 & day +60 post-alloSCT for 65 patients. T-cells harbouring TRB sequences with annotated specificity for CMV were identifiable in all patients. 56% of patients required CMV treatment and 23% of the cohort developed recurrent CMV. PubCMVrep size at day +30 was not associated with reactivation, however amongst patients with antecedent CMV viremia a low day +60 pubCMVrep was associated with a greater incidence of recurrent CMV (75% vs. 21%, HR 6.16, 95% CI 1.29-29.40, P = 0.0008). Moreover, patients with high pubCMVrep only developed recurrent CMV in the setting of GVHD. Low TCR diversity at day +30 was associated with a greater incidence of initial CMV reactivation (71% vs. 22%, HR 5.39, 95% CI 1.70-17.09, p = 0.0002). pubCMVrep and TCR diversity are promising biomarkers to identify patients at risk of initial & recurrent CMV who may benefit from novel prophylactic strategies.
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Affiliation(s)
- James A Kuzich
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
| | - Yamuna Kankanige
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,University of Melbourne, Parkville, VIC, Australia
| | - Jerick Guinto
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Georgina Ryland
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,University of Melbourne, Parkville, VIC, Australia
| | - Michelle McBean
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Eric Wong
- University of Melbourne, Parkville, VIC, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre & the Royal Melbourne Hospital, Melbourne, VIC, Australia.,ACRF Translational Research Laboratory, Royal Melbourne Hospital, Parkville, VIC, Australia.,Department of Clinical Haematology, Austin Hospital, Heidelberg, VIC, Australia
| | - Rachel Koldej
- University of Melbourne, Parkville, VIC, Australia.,ACRF Translational Research Laboratory, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Jenny Collins
- Clinical Haematology, Peter MacCallum Cancer Centre & the Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - David Westerman
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,University of Melbourne, Parkville, VIC, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre & the Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - David Ritchie
- University of Melbourne, Parkville, VIC, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre & the Royal Melbourne Hospital, Melbourne, VIC, Australia.,ACRF Translational Research Laboratory, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Piers Blombery
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,University of Melbourne, Parkville, VIC, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre & the Royal Melbourne Hospital, Melbourne, VIC, Australia
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6
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Thompson ER, Nguyen T, Kankanige Y, Yeh P, Ingbritsen M, McBean M, Semple T, Mir Arnau G, Burbury K, Lee N, Khot A, Westerman D, Blombery P. Clonal independence of JAK2 and CALR or MPL mutations in comutated myeloproliferative neoplasms demonstrated by single cell DNA sequencing. Haematologica 2021; 106:313-315. [PMID: 32817290 PMCID: PMC7776355 DOI: 10.3324/haematol.2020.260448] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Ella R Thompson
- Pathology and Oncology Department, Peter MacCallum Cancer Centre, Melbourne
| | - Tamia Nguyen
- Pathology Department, Peter MacCallum Cancer Centre, Melbourne
| | - Yamuna Kankanige
- Pathology and Oncology Department, Peter MacCallum Cancer Centre, Melbourne
| | - Paul Yeh
- Peter MacCallum Cancer Centre, Melbourne
| | | | - Michelle McBean
- Pathology Department, Peter MacCallum Cancer Centre, Melbourne
| | - Timothy Semple
- Research Division, Peter MacCallum Cancer Centre, Melbourne
| | - Gisela Mir Arnau
- Department of Oncology, Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Kate Burbury
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne
| | - Nora Lee
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne
| | - Amit Khot
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne
| | - David Westerman
- Pathology, Oncology and Clinical Hematology, Peter MacCallum Cancer Centre, Melbourne
| | - Piers Blombery
- Pathology, Oncology and Clinical Haematology, Peter MacCallum Cancer Centre, Melbourne
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7
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Blombery P, Fox L, Ryland GL, Thompson ER, Lickiss J, McBean M, Yerneni S, Hughes D, Greenway A, Mechinaud F, Wood EM, Lieschke GJ, Szer J, Barbaro P, Roy J, Wight J, Lynch E, Martyn M, Gaff C, Ritchie D. Utility of clinical comprehensive genomic characterization for diagnostic categorization in patients presenting with hypocellular bone marrow failure syndromes. Haematologica 2021; 106:64-73. [PMID: 32054657 PMCID: PMC7776333 DOI: 10.3324/haematol.2019.237693] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/07/2020] [Indexed: 12/26/2022] Open
Abstract
Bone marrow failure (BMF) related to hypoplasia of hematopoietic elements in the bone marrow is a heterogeneous clinical entity with a broad differential diagnosis including both inherited and acquired causes. Accurate diagnostic categorization is critical to optimal patient care and detection of genomic variants in these patients may provide this important diagnostic and prognostic information. We performed real-time, accredited (ISO15189) comprehensive genomic characterization including targeted sequencing and whole exome sequencing in 115 patients with BMF syndromes (median age 24 years, range: 3 months - 81 years). In patients with clinical diagnoses of inherited BMF syndromes, acquired BMF syndromes or clinically unclassifiable BMF we detected variants in 52% (12 of 23), 53% (25 of 47) and 56% (25 of 45) respectively. Genomic characterization resulted in a change of diagnosis in 30 of 115 (26%) including the identification of germline causes for 3 of 47 and 16 of 45 cases with pre-test diagnoses of acquired and clinically unclassifiable BMF respectively. The observed clinical impact of accurate diagnostic categorization included choice to perform allogeneic stem cell transplantation, disease-specific targeted treatments, identification of at-risk family members and influence of sibling allogeneic stem cell donor choice. Multiple novel pathogenic variants and copy number changes were identified in our cohort including in TERT, FANCA, RPS7 and SAMD9. Whole exome sequence analysis facilitated the identification of variants in two genes not typically associated with a primary clinical manifestation of BMF but also demonstrated reduced sensitivity for detecting low level acquired variants. In conclusion, genomic characterization can improve diagnostic categorization of patients presenting with hypoplastic BMF syndromes and should be routinely performed in this group of patients.
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Affiliation(s)
- Piers Blombery
- Clinical Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Lucy Fox
- Clinical Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Georgina L Ryland
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ella R Thompson
- University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Jennifer Lickiss
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Michelle McBean
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Satwica Yerneni
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | | | | | - Erica M Wood
- Transfusion Research Unit, Monash University, Melbourne
| | - Graham J Lieschke
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne
| | - Jeff Szer
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne
| | - Pasquale Barbaro
- Children Health Queensland and University of Queensland, South Brisbane, QLD
| | - John Roy
- Children Health Queensland and University of Queensland, South Brisbane, QLD
| | - Joel Wight
- Department of Hematology, Austin Health, Melbourne
| | - Elly Lynch
- Melbourne Genomics Health Alliance, Parkville VIC, Australia
| | | | - Clara Gaff
- Melbourne Genomics Health Alliance, Parkville VIC, Australia
| | - David Ritchie
- Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne, Australia
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8
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Thompson ER, Lim KJC, Kuzich JA, McBean M, Westerman D, Tam CS, Blombery P. Detection of an IGH- BRAF fusion in a patient with BRAF Val600Glu negative hairy cell leukemia. Leuk Lymphoma 2020; 61:2024-2026. [PMID: 32319330 DOI: 10.1080/10428194.2020.1753045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Ella R Thompson
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Kenneth J C Lim
- Department of Haematology, St Vincent's Hospital, Melbourne, Australia
| | - James A Kuzich
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Michelle McBean
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - David Westerman
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne, Australia
| | - Constantine S Tam
- Department of Haematology, St Vincent's Hospital, Melbourne, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Piers Blombery
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre/Royal Melbourne Hospital, Melbourne, Australia
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9
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Kuzich JA, Kankanige Y, Guinto J, Ryland G, McBean M, Thompson E, Wong E, Koldej R, Collins J, Westerman D, Ritchie DS, Blombery P. Quantitation of CMV Specific T-Cell Expansion Using T Cell Receptor Beta Locus Deep Sequencing to Identify Patients at Risk of Viral Complications. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Gould C, McBean M, Thompson E, Westerman D, Blombery P. Observations from a national multi-sample exchange program for molecular haematology testing. Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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11
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Blombery P, Jones K, Doig K, Ryland G, McBean M, Thompson E, Yannakou CK, Westerman D. Sensitive NPM1 Mutation Quantitation in Acute Myeloid Leukemia Using Ultradeep Next-Generation Sequencing in the Diagnostic Laboratory. Arch Pathol Lab Med 2018; 142:606-612. [PMID: 29425073 DOI: 10.5858/arpa.2017-0229-oa] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context Detection of measurable residual disease after therapy is an important predictor of outcome in acute myeloid leukemia. Objective To investigate the feasibility of using next-generation sequencing (NGS) in the diagnostic laboratory to perform quantitative NPM1 mutation assessment using ultradeep (approximately 300 000×-500 000×) sequencing (NGS-q NPM1) as a method of assessing residual disease burden in patients with acute myeloid leukemia. Design A flexible NGS-based assay for the detection and quantitation of NPM1 mutations was developed by polymerase chain reaction amplification of target DNA sequences, sequencing on an Illumina (San Diego, California) MiSeq, and analyzing data with an in-house-designed bioinformatic pipeline. NGS-q NPM1 was compared with current NPM1 quantitation methods (real-time quantitative-polymerase chain reaction and multiparameter flow cytometry). Results The NGS-q NPM1 assay had a sensitivity of between 10-4 and 10-5 and showed high concordance and correlation with reference methodologies. Moreover, the NGS-q NPM1 assay was able to be integrated into the laboratory's existing, targeted amplicon-based sequencing workflow. Conclusions An NGS-based, quantitative NPM1-mutation assessment can be used to monitor patients with acute myeloid leukemia, and it has some practical advantages over existing modalities.
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Affiliation(s)
| | | | | | | | | | | | | | - David Westerman
- From the Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia (Drs Blombery, Jones, Ryland, Thompson, Yannakou, and Westerman; Mr Doig; and Ms McBean); and the Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia (Drs Blombery, Thompson, Yannakou, and Westerman). Drs Blombery and Jones contributed equally to this work
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12
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Yannakou CK, Jones K, McBean M, Thompson ER, Ryland GL, Doig K, Markham J, Westerman D, Blombery P. ASXL1 c.1934dup;p.Gly646Trpfs*12-a true somatic alteration requiring a new approach. Blood Cancer J 2017; 7:656. [PMID: 29242575 PMCID: PMC5802455 DOI: 10.1038/s41408-017-0025-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 10/11/2017] [Indexed: 12/31/2022] Open
Affiliation(s)
- Costas K Yannakou
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia. .,University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Kate Jones
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Michelle McBean
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Ella R Thompson
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.,University of Melbourne, Parkville, VIC, 3010, Australia
| | | | - Ken Doig
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - John Markham
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.,University of Melbourne, Parkville, VIC, 3010, Australia
| | - David Westerman
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.,University of Melbourne, Parkville, VIC, 3010, Australia
| | - Piers Blombery
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.,University of Melbourne, Parkville, VIC, 3010, Australia
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13
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Blombery PA, Ryland GL, Markham J, Guinto J, Wall M, McBean M, Jones K, Thompson ER, Cameron DL, Papenfuss AT, Prince MH, Dickinson M, Westerman DA. Detection of clinically relevant early genomic lesions in B-cell malignancies from circulating tumour DNA using a single hybridisation-based next generation sequencing assay. Br J Haematol 2017; 183:146-149. [DOI: 10.1111/bjh.14919] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - John Markham
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - Jerick Guinto
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - Meaghan Wall
- Victorian Cancer Cytogenetics Service; Melbourne Vic. Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Vic. Australia
- St Vincent's Institute of Medical Research; Fitzroy Vic. Australia
| | | | - Kate Jones
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - Ella R. Thompson
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Vic. Australia
| | - Daniel L. Cameron
- Walter and Eliza Hall Institute of Medical Research; Melbourne Vic. Australia
| | - Anthony T. Papenfuss
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Vic. Australia
- Walter and Eliza Hall Institute of Medical Research; Melbourne Vic. Australia
| | - Miles H. Prince
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Vic. Australia
| | - Michael Dickinson
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Vic. Australia
| | - David Alan Westerman
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Vic. Australia
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Yannakou CK, Jones K, Ryland GL, Thompson ER, Reid G, McBean M, Trainer A, Westerman D, Blombery P. Incidental detection of germline variants of potential clinical significance by massively parallel sequencing in haematological malignancies. J Clin Pathol 2017; 71:84-87. [DOI: 10.1136/jclinpath-2017-204481] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/14/2017] [Accepted: 07/19/2017] [Indexed: 12/15/2022]
Abstract
Massively parallel sequencing (MPS) technology has become routinely available for diagnosis, prognostication and therapeutic decision-making in haematological malignancies. However, increased throughput and wider coverage of genes can have unintended consequences. Germline variants of potential clinical significance (GVPCSs) detected during cancer testing may have implications for patients and families beyond the biological evaluation of a specific tumour. 721 reports generated from MPS panels used in the routine testing of myeloid and lymphoid malignancies were reviewed and variants within genes of potential germline relevance (TP53, RUNX1, GATA2 and WT1 in all contexts and CBL, KRAS and NRAS in the setting of juvenile myelomonocytic leukaemia) were analysed. A variant allele fraction threshold of ≥33.09% for considering germline origin of variants within cancer samples was established. The detection rate of incidental, pathogenic germline variants was 0.42%. Patient education and confirmatory germline sample testing of GVPCSs in appropriate circumstances are recommended.
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15
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Ryland GL, Jones K, McBean M, Khot A, Seymour JF, Blombery P. Comprehensive genomic characterization dissects the complex biology of a case of synchronous Burkitt lymphoma and myeloid malignancy with shared hematopoietic ancestry. Leuk Lymphoma 2017; 59:992-995. [PMID: 28792266 DOI: 10.1080/10428194.2017.1361029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Georgina L Ryland
- a Department of Pathology , Peter MacCallum Cancer Centre , Melbourne , Australia
| | - Kate Jones
- a Department of Pathology , Peter MacCallum Cancer Centre , Melbourne , Australia
| | - Michelle McBean
- a Department of Pathology , Peter MacCallum Cancer Centre , Melbourne , Australia
| | - Amit Khot
- b Department of Haematology , Peter MacCallum Cancer Centre , Melbourne , Australia
| | - John Francis Seymour
- b Department of Haematology , Peter MacCallum Cancer Centre , Melbourne , Australia.,c Faculty of Medicine, Dentistry and Health Science, University of Melbourne , Melbourne , Australia
| | - Piers Blombery
- a Department of Pathology , Peter MacCallum Cancer Centre , Melbourne , Australia.,b Department of Haematology , Peter MacCallum Cancer Centre , Melbourne , Australia
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16
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Cross NCP, White HE, Ernst T, Welden L, Dietz C, Saglio G, Mahon FX, Wong CC, Zheng D, Wong S, Wang SS, Akiki S, Albano F, Andrikovics H, Anwar J, Balatzenko G, Bendit I, Beveridge J, Boeckx N, Cerveira N, Cheng SM, Colomer D, Czurda S, Daraio F, Dulucq S, Eggen L, El Housni H, Gerrard G, Gniot M, Izzo B, Jacquin D, Janssen JJWM, Jeromin S, Jurcek T, Kim DW, Machova-Polakova K, Martinez-Lopez J, McBean M, Mesanovic S, Mitterbauer-Hohendanner G, Mobtaker H, Mozziconacci MJ, Pajič T, Pallisgaard N, Panagiotidis P, Press RD, Qin YZ, Radich J, Sacha T, Touloumenidou T, Waits P, Wilkinson E, Zadro R, Müller MC, Hochhaus A, Branford S. Development and evaluation of a secondary reference panel for BCR-ABL1 quantification on the International Scale. Leukemia 2016; 30:1844-52. [PMID: 27109508 PMCID: PMC5240017 DOI: 10.1038/leu.2016.90] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/11/2016] [Indexed: 12/24/2022]
Abstract
Molecular monitoring of chronic myeloid leukemia patients using robust BCR-ABL1 tests standardized to the International Scale (IS) is key to proper disease management, especially when treatment cessation is considered. Most laboratories currently use a time-consuming sample exchange process with reference laboratories for IS calibration. A World Health Organization (WHO) BCR-ABL1 reference panel was developed (MR1–MR4), but access to the material is limited. In this study, we describe the development of the first cell-based secondary reference panel that is traceable to and faithfully replicates the WHO panel, with an additional MR4.5 level. The secondary panel was calibrated to IS using digital PCR with ABL1, BCR and GUSB as reference genes and evaluated by 44 laboratories worldwide. Interestingly, we found that >40% of BCR-ABL1 assays showed signs of inadequate optimization such as poor linearity and suboptimal PCR efficiency. Nonetheless, when optimized sample inputs were used, >60% demonstrated satisfactory IS accuracy, precision and/or MR4.5 sensitivity, and 58% obtained IS conversion factors from the secondary reference concordant with their current values. Correlation analysis indicated no significant alterations in %BCR-ABL1 results caused by different assay configurations. More assays achieved good precision and/or sensitivity than IS accuracy, indicating the need for better IS calibration mechanisms.
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Affiliation(s)
- N C P Cross
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - H E White
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - T Ernst
- Department of Hematology/Oncology, Universitätsklinikum Jena, Jena, Germany
| | - L Welden
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia
| | - C Dietz
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - G Saglio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - F-X Mahon
- Bergonie Institute Cancer Center Bordeaux, INSERM U1218, University of Bordeaux, Bordeaux, France
| | - C C Wong
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - D Zheng
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Wong
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S-S Wang
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Akiki
- West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - F Albano
- Department of Hematology, University of Bari, Bari, Italy
| | - H Andrikovics
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.,Department of Pathophysiology, Semmelweis University, Budapest, Hungary
| | - J Anwar
- King's College Hospital London, London, UK
| | - G Balatzenko
- National Specialized Hospital for Active Treatment of Hematological Diseases, Sofia, Bulgaria
| | - I Bendit
- Laboratorio de Biologia Tumoral, Disciplina de Hematologia do HC-FMUSP, São Paulo, Brazil
| | - J Beveridge
- PathWest Laboratory Medicine WA, Department of Haematology, Fiona Stanley Hospital, Perth, WA, Australia
| | - N Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KUL, Leuven, Belgium
| | - N Cerveira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - S-M Cheng
- Department of Hematology and Oncology, Quest Diagnostics Nichols Institute, San Juan Capistrano, CA, USA
| | - D Colomer
- Hematopathology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - S Czurda
- Division of Molecular Microbiology, Children's Cancer Research Institute, Vienna, Austria
| | - F Daraio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - S Dulucq
- Laboratoire Hematologie, Centre Hospitalier Universitaire de Bordeaux, Universite Bordeaux, Bordeaux, France
| | - L Eggen
- Laboratory of Molecular Pathology, Oslo University Hospital, Oslo, Norway
| | - H El Housni
- Clinique de Genetique Oncologique-Service de genetique, Hopital Erasme, Brussels, Belgium
| | - G Gerrard
- Imperial Molecular Pathology, Hammersmith Hospital, London, UK
| | - M Gniot
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - B Izzo
- Department of Clinical Medicine and Surgery, University 'Federico II' of Naples, Naples, Italy.,CEINGE - Biotecnologie Avanzate, Naples, Italy
| | | | - J J W M Janssen
- Department of Hematology and Molecular Diagnostics, VU University Medical Center, Amsterdam, The Netherlands
| | - S Jeromin
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - T Jurcek
- Center of Molecular Biology and Gene Therapy, Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - D-W Kim
- Seoul St Mary's Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea
| | - K Machova-Polakova
- Department of Molecular Genetics, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - J Martinez-Lopez
- Department of Hematology, Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO, Madrid, Spain
| | - M McBean
- Division of Cancer Medicine, Department of Pathology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - S Mesanovic
- Pathology Department, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - G Mitterbauer-Hohendanner
- Department of Laboratory Medicine, Division of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | | | - M-J Mozziconacci
- Departement de Biopathologie, Institut Paoli-Calmettes, Marseille, France
| | - T Pajič
- Specialized Haematology Laboratory, Department of Haematology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - N Pallisgaard
- Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark
| | - P Panagiotidis
- Hematology Unit, First Department of Internal Medicine, Laiko Hospital, University of Athens, Athens, Greece
| | - R D Press
- Department of Pathology and Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Y-Z Qin
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China
| | - J Radich
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - T Sacha
- Chair and Department of Hematology, Jagiellonian University, Kraków, Poland
| | - T Touloumenidou
- Laboratory of Molecular Biology, Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - P Waits
- Bristol Genetics Laboratory, Bristol, UK
| | | | - R Zadro
- Faculty of Pharmacy and Biochemistry and University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia
| | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Hochhaus
- Department of Hematology/Oncology, Universitätsklinikum Jena, Jena, Germany
| | - S Branford
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia.,School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA, Australia.,School of Medicine, University of Adelaide, SA, Adelaide, Australia.,School of Molecular and Biomedical Science, University of Adelaide, Adelaide, SA, Australia
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17
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Agarwal R, McBean M, Hewitt C, Westerman DA. KITD816V mutation detection: a comparative study using peripheral blood, bone marrow aspirate and bone marrow trephine samples for detection ofKITmutations in patients with systemic mastocytosis. Leuk Lymphoma 2014; 55:2202-3. [DOI: 10.3109/10428194.2013.876498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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18
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Zapparoli GV, Jorissen RN, Hewitt CA, McBean M, Westerman DA, Dobrovic A. Quantitative threefold allele-specific PCR (QuanTAS-PCR) for highly sensitive JAK2 V617F mutant allele detection. BMC Cancer 2013; 13:206. [PMID: 23617802 PMCID: PMC3658971 DOI: 10.1186/1471-2407-13-206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 03/26/2013] [Indexed: 02/03/2023] Open
Abstract
Background The JAK2 V617F mutation is the most frequent somatic change in myeloproliferative neoplasms, making it an important tumour-specific marker for diagnostic purposes and for the detection of minimal residual disease. Sensitive quantitative assays are required for both applications, particularly for the monitoring of minimal residual disease, which requires not only high sensitivity but also very high specificity. Methods We developed a highly sensitive probe-free quantitative mutant-allele detection method, Quantitative Threefold Allele-Specific PCR (QuanTAS-PCR), that is performed in a closed-tube system, thus eliminating the manipulation of PCR products. QuantTAS-PCR uses a threefold approach to ensure allele-specific amplification of the mutant sequence: (i) a mutant allele-specific primer, (ii) a 3′dideoxy blocker to suppress false-positive amplification from the wild-type template and (iii) a PCR specificity enhancer, also to suppress false-positive amplification from the wild-type template. Mutant alleles were quantified relative to exon 9 of JAK2. Results We showed that the addition of the 3′dideoxy blocker suppressed but did not eliminate false-positive amplification from the wild-type template. However, the addition of the PCR specificity enhancer near eliminated false-positive amplification from the wild-type allele. Further discrimination between true and false positives was enabled by using the quantification cycle (Cq) value of a single mutant template as a cut-off point, thus enabling robust distinction between true and false positives. As 10,000 JAK2 templates were used per replicate, the assay had a sensitivity of 1/10-4 per replicate. Greater sensitivity could be reached by increasing the number of replicates analysed. Variation in replicates when low mutant-allele templates were present necessitated the use of a statistics-based approach to estimate the load of mutant JAK2 copies. QuanTAS-PCR showed comparable quantitative results when validated against a commercial assay. Conclusions QuanTAS-PCR is a simple, cost-efficient, closed-tube method for JAK2 V617F mutation quantification that can detect very low levels of the mutant allele, thus enabling analysis of minimal residual disease. The approach can be extended to the detection of other recurrent single nucleotide somatic changes in cancer.
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Affiliation(s)
- Giada V Zapparoli
- Department of Pathology, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Victoria 3002, Australia
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Hewitt C, McBean M, Tan A, Dobrovic A, McArthur G, Westerman D. Mutation analysis for systemic mastocytosis. Pathology 2011. [DOI: 10.1016/s0031-3025(16)33175-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Elliott S, Bland P, Yu X, Caldwell D, McBean M. MP-05.13: National trends in the surgical therapy of benign prostatic hyperplasia in the United States (2002-2008). Urology 2010. [DOI: 10.1016/j.urology.2010.07.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Yu X, Elliott S, Wilt T, McBean M. MP-20.20: BPH surgical treatment trends in the U.S. – the dramatic increase in the application of minimally invasive technologies. Urology 2007. [DOI: 10.1016/j.urology.2007.06.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Abstract
Electronically available administrative data are increasingly used by public health researchers and planners. The validity of the data source has been established, and its strengths and weaknesses relative to data abstracted from medical records and obtained via survey are documented. Administrative data are available from a variety of state, federal, and private sources and can, in many cases, be combined. As a tool for planning and surveillance, administrative data show great promise: They contain consistent elements, are available in a timely manner, and provide information about large numbers of individuals. Because they are available in an electronic format, they are relatively inexpensive to obtain and use. In the United States, however, there is no administrative data set covering the entire population. Although Medicare provides health care for an estimated 96% of the elderly, age 65 years and older, there is no comparable source for those under 65.
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Affiliation(s)
- B A Virnig
- Division of Health Services Research and Policy, University of Minnesota School of Public Health, MMC 97, A365, 420 Delaware Street SE, Minneapolis, Minnesota 55455, USA.
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McBean M, Rajamani S. Increasing rates of hospitalization due to septicemia in the US elderly population, 1986-1997. J Infect Dis 2001; 183:596-603. [PMID: 11170985 DOI: 10.1086/318526] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2000] [Revised: 10/19/2000] [Indexed: 11/03/2022] Open
Abstract
Rates of hospitalization due to septicemia (International Classification of Diseases, Ninth Revision, Clinical Modification, code 038) in the US elderly population for 1986-1997 were examined, using Medicare administrative data. Age group-, sex-, and race-adjusted rates more than doubled from 1986 through 1997, from 3.42 to 7.42 per 1000 beneficiaries. The 1997 rates of septicemia increased with age, from 4.47 per 1000 beneficiaries among persons 65-74 years old to 18.1 per 1000 beneficiaries among persons > or =85 years old. The rates of septicemia were slightly greater among men (7.46 per 1000 beneficiaries) than among women (7.39 per 1000 beneficiaries) and were higher among blacks (13.61 per 1000 beneficiaries) than among whites (6.89 per 1000 beneficiaries). The most likely sites of the origin of the septicemia were the urinary tract (40.1%) and lungs (15.3%). Escherichia coli and Staphylococcus species were the most frequently reported organisms. Diabetes was listed as a comorbidity in 24.5% of the hospitalizations. We estimate that the cost to Medicare for septicemia hospitalizations in 1997 was >$1.8 billion.
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Affiliation(s)
- M McBean
- Division of Health Services Research and Policy, University of Minnesota School of Public Health, Box 97, D355 Mayo Memorial Building, 420 Delaware St. SE, Minneapolis, MN 55455, USA.
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Abstract
OBJECTIVES To examine national variation in use of the Medicare hospice benefit by older individuals before their death, and to identify individual characteristics and local market factors associated with hospice use. DESIGN Retrospective analysis of Medicare administrative data. SETTING Hospice care. PARTICIPANTS Older Medicare enrollees who died in 1996. MEASUREMENTS Rate of hospice use per 1,000 older Medicare beneficiary deaths. RESULTS Overall, 155 of every 1,000 older Medicare beneficiaries who die use hospice before death. This rate is significantly higher among younger older persons (P < .001), non-blacks (P < .001), persons living in wealthier areas (P < .001), and persons in urban areas (P < .001). Areas with a higher proportion of non-cancer diagnoses among hospice users have higher rates of hospice use for both cancer and non-cancer reasons than areas with a majority of hospice users having cancer diagnoses (P < .001). Hospice use is higher in areas with fewer hospital beds per capita (P < .001), areas with lower in-hospital death rates (P < .001), and areas with higher HMO enrollment (P < .001). Rates of hospice use are also positively related to average reimbursements for health care (P < .001) and to physicians per capita (P < .001). In the largest metropolitan statistical areas (MSAs), rates of hospice use vary more than 11-fold from a low of 35.15 (Portland, ME) to a high of 397.2 per 1,000 deaths (Ft. Lauderdale, FL). CONCLUSIONS The wide variation in hospice use suggests that there is great potential to increase the number of users of the Medicare hospice benefit.
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Affiliation(s)
- B A Virnig
- Division of Health Services Research and Policy, University of Minnesota School of Public Health, Minneapolis 55455, USA
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Abstract
BACKGROUND One challenge in medical education is to provide training in physical examination skills. The authors conducted a randomized study to compare standardized and unstandardized methods of teaching clinical breast examinations and to determine whether trained non-medical women could teach as well as medical faculty. METHOD Sensitivity, specificity, and examination techniques were compared between first-year students at the University of Calgary Faculty of Medicine who in 1992-93 received standardized teaching from family medicine faculty or well women teachers and 70 second-year students who received unstandardized teaching during their clinical rotations. Standardized teaching included a specific examination technique using silicone breast models. The students taught by the well women teachers also examined the women's breasts. RESULTS The standardized-teaching group had more consistent examination techniques and significantly higher sensitivity but lower specificity. The students taught by the well women teachers performed as well as those taught by the family medicine faculty. CONCLUSIONS The teaching methods used by trained teachers and standardized models improved the students'accuracy of breast lump detection and examination skills.
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Affiliation(s)
- H S Campbell
- Division of Epidemiology and Preventive Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
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Abstract
Rehospitalization following surgery is widely recognized as an important outcome measure. The purpose of this study was to identify rehospitalizations for adverse events following 8 procedures, using diagnosis and procedure codes contained in Medicare claims files. Adverse events were broadly defined as: 1) complications; 2) failure of the procedure to achieve its therapeutic goal; and 3) untoward events associated with the natural history of the disease being treated with the procedure. Expert panels identified specific diagnosis and procedure codes that might indicate an adverse event if they appeared on the Medicare record of a rehospitalization. Among patients undergoing percutaneous transluminal coronary angioplasty, almost 36% were rehospitalized for an adverse event within a year of surgery; among patients undergoing coronary artery bypass graft surgery, 20% were rehospitalized for an adverse event. Following the other 6 procedures (cholecystectomy, partial excision of the large intestine, total knee replacement, total hip replacement, replacement of the head of the femur, and reduction of fracture of the femur) between 4% and 9% of patients were rehospitalized for an adverse event. Findings from this exploratory study indicate that rehospitalizations for adverse events appear to be a useful outcome measure for the cardiac procedures; they appear to be less useful for the other procedures, at least at the individual hospital or small area level, because of their relative rarity. Future studies should investigate procedures associated with more frequent rehospitalizations, and medical admissions, which often tend to be associated with higher rehospitalization levels.
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Affiliation(s)
- G Riley
- Office of Research and Demonstrations, Health Care Financing Administration, Baltimore, MD
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Laing LM, Higgins G, Szafran O, McBean M. Physicians' practice patterns: a reflection of personal values? J Ambul Care Manage 1993; 16:75-87. [PMID: 10126594 DOI: 10.1097/00004479-199307000-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L M Laing
- Department of Health Services Administration and Community Medicine, University of Alberta, Edmonton, Canada
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Gateff C, Ravisse P, Monchicourt D, McBean M, Labusquière R. [The penetration of BCG vaccine innoculated by an injector under pressure provided with a recoil ring]. Bull Soc Pathol Exot Filiales 1974; 67:140-8. [PMID: 4480520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Gateff C, McBean M, Monchicourt D, Labusquière R. [Study of BCG vaccination by multiple pressure technic with bifurcate needles]. Bull Int Union Tuberc 1973; 48 Suppl:29-38. [PMID: 4807568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Gateff C, Relyveld EH, Le Gonidec G, Vincent J, Labusquière R, McBean M, Monchicourt D, Chambon L. [Study of a new pentavalent vaccine combination]. Ann Microbiol (Paris) 1973; 124:387-409. [PMID: 4791967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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