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March 2016

Immunotherapy steers focus to microenvironment

March 2016—It’s not every day that a monoclonal antibody leads the news. But when former president Jimmy Carter was successfully treated for metastasized melanoma last year with the new drug pembrolizumab (Keytruda), the story made headlines. Carter’s recovery—surprising to many when it was announced in December—may have been helped by traditional radiation and chemotherapy. However, the role played by pembrolizumab spotlighted immunotherapy as an exciting advance in the evolution of cancer treatment.

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Cutting cultures: the move to all molecular in virology

March 2016—For laboratories performing virology testing, taking advantage of molecular testing’s superiority to traditional testing methods is a no-brainer. But leaders in the University of Michigan’s clinical microbiology laboratory have found that the push to go all molecular for virology testing must be tempered by attentiveness to clinician preferences and a collaborative approach that’s likelier to make the journey a success.

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Lab shoots for better phlebotomy service, satisfied patients

March 2016—Try running a race and tying your shoes at the same time. That is the kind of challenge laboratories face when they endeavor to refine their processes while providing all the usual services clinicians and patients expect. When laboratory leaders at Brigham and Women’s Hospital in Boston surveyed the landscape of their phlebotomy operations, they spotted many opportunities for improvement through Lean Kaizen events as well as technology that reduces the risk of human error.

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Anatomic Pathology Abstracts, 3/16

March 2016—Reproducibility of residual cancer burden for assessing breast cancer after neoadjuvant chemotherapy: The residual cancer burden index was developed to quantify residual disease ranging from pathological complete response to extensive residual disease. The authors conducted a study to evaluate inter-pathologist reproducibility in the residual cancer burden index score and category and in their long-term prognostic utility.

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Molecular Pathology Selected Abstracts, 3/16

March 2016—Enhancing tumor selectivity of a picornavirus virotherapy: Oncolytic viruses that selectively target tumor cells are a promising cancer therapy and are thought to work not only via direct lysis and destruction of tumor cells but also through recruitment and activation of the host’s anti-tumor immune response. While there are a number of naturally occurring viruses that preferentially replicate in cancer cells and have otherwise limited effects in human tissue, the real therapeutic promise lies in genetically engineered viruses.

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Clinical Pathology Abstracts, 3/16

March 2016—Impact of add-on laboratory testing at an academic medical center: Clinical laboratories are often asked to perform additional laboratory tests after the original sample is received and testing per the original order is complete. It is well known that this significantly increases laboratory workload and impacts turnaround time.

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Q&A column, 3/16

March 2016—I have a question regarding auto-verification delta checks, not for a single patient but between all patients tested during a given period. Are there labs that use postanalytic comparisons of clinical lab results during the testing interval between quality assurance checks to ascertain if the autoverified results being released are reasonable?

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Liquid biopsy—much to do about something

March 2016—Lynette Sholl, MD, isn’t fully sold on that hottest of feverishly hot topics, liquid biopsy. “It’s kind of a sexy colloquialism, I suppose,” says Dr. Sholl, associate director, Center for Advanced Molecular Diagnostics, and associate pathologist, Brigham and Women’s Hospital, Boston. “Is there an official definition?”

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Broadening the productivity spectrum with middleware

March 2016—As James Beck, MT(ASCP), remembers it, middleware was introduced at his institution about the same time that the nursing department decided connectivity should be the province of the laboratory. When the concept of docking and interfacing glucose testing devices came on the scene around the turn of the millennium, that was a turning point, says Beck, who is point-of-care testing coordinator for the University of Pittsburgh Medical Center–St. Margaret, which uses the Telcor middleware solution QML.

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Roads cross in clonal hematopoiesis and stem cell studies

March 2016—At the annual meeting of the Association for Molecular Pathology in November 2015, one plenary session was called “Exciting Times for Translational Research in Molecular Hematology.” In accord with the title, Margaret Goodell, PhD, gave an exciting talk about how hematopoietic stem cells are regulated in mice. While Dr. Goodell’s basic research was impressive, what was most remarkable was how it meshed with and anticipated research in human hematopoietic malignancies from other laboratories.

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Newsbytes, 3/16

March 2016—Digital consults: options for getting from here to there: The U.S. digital pathology consultation marketplace is steadily gaining ground, largely owing to increased demand for international consultations. And those delving into digital consults are making a three-pronged decision: build your own system, install an off-the-shelf software solution, or sign up with a Web-based digital consultation network.

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Put It on the Board, 3/16

March 2016—Case raises uncertainty on autopsy’s legal status: Should a hospital-provided autopsy be considered health care? It’s a question the Supreme Court of Texas will decide this spring, and its answer to that question will make a big difference—in the millions of dollars—to the claimants, Christus Health Gulf Coast v. Carswell. It could also have an impact on the medical liability coverage available to pathologists who perform autopsies in the Lone Star State.

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