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    Trainee Presentation Session 2021

    The Hong Kong College of Pathologists

    27 Nov 2021 9:00 to 12:30

    2019冠狀病毒病疫苗資訊

    Information related to Covid19-Vaccination for Public

    PRESS STATEMENT

    Use of Over-the-counter COVID-19 Test Kits

    就市面上出售的新型冠狀病毒快速測試之聲明

    Medical Training4

    Medical Training4

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    Measurable residual disease (MRD) for Haematological Malignancy

    Thu, 2022-05-26 11:27

    Measurable residual disease (MRD) for Haematological Malignancy


    Volume 17, Issue 1, January 2022  (download full article in pdf)


    Editorial note:


    Measurable residual disease (MRD) monitoring has emerged as an important indicator for risk stratification and treatment planning in patients with haematological malignancies. In the past decade, various techniques in measuring MRD have become available in Hong Kong. In this Topical Update, Dr. YIP Sze-fai provides an overview of the current techniques available for MRD monitoring. We welcome any feedback or suggestions. Please direct them to Dr. Alvin IP of Education Committee, the Hong Kong College of Pathologists. Opinions expressed are those of the authors or named individuals, and are not necessarily those of the Hong Kong College of Pathologists.



    Dr. YIP Sze-fai

    Consultant Haematologist, Department of Clinical Pathology, Tuen Mun Hospital



    Introduction


    Measurable residual disease (MRD) describes the application of assays for detection of submicroscopic level of residual disease burden which cannot be detected by morphology. Numerous studies have observed the association of MRD level and disease prognosis. It provides an objective parameter on the tumor burden, and guide stratified treatment including the application of haemopoietic stem cell transplantation (HSCT). Its ability to monitor disease and to detect molecular relapse enables preemptive therapy to prevent frank disease relapse [1]. For all these reasons, we see an increasing use of MRD in the field of haematological malignancy.


    Different technologies are used for MRD measurement


    1. Multiparametric flow cytometry (MFC)

    MFC is commonly used for MRD detection in acute leukaemias. At diagnosis, the leukaemia-associated immunophenotype (LAIP) of the blasts can be determined by using a multitude of fluorochrome-labeled monoclonal antibodies against different cellular markers that aids identification of the leukaemic population as well as detecting the aberrant cellular marker expression. If the LAIP was not determined at diagnosis, a different-from-normal (DfN) approach can be used to detect the abnormal cells, as well as detecting any new or disappearance of known phenotypic aberrancies [1,2]. With technological advancement, more fluorochromes are available and 8 to 12-colour panels are commonly used. Flow cytometry has the advantage of a short turnaround time which can provide timely results for clinical decision making. The sensitivity of MRD detection is at the level of 10-4 to 10-5.


    2. Next generation flow (NGF) for plasma cell myeloma

    Novel Euroflow-based next generation flow (NGF) approach is being developed for highly sensitive and standardized MRD detection, primarily in plasma cell myeloma, using an optimized 2-tube 8-color antibody panel [3]. The NGF approach uses tools and procedures that are developed by the EuroFlow Consortium for a standardized sample preparation, antibody panel (including the type of antibody and fluorochrome), and automatic identification of plasma cells against reference databases of normal and patient BM using Infinicyt software. The sensitivity of MRD detection is close to 10-6.


    3. Quantitative polymerase chain reaction (qPCR) technique

    a. Detection of leukaemia-specific fusion transcript

    The MRD can be measured by detecting the amount of leukaemia-specific fusion transcripts present. The classical example is BCR-ABL1 fusion in chronic myeloid leukaemia (CML). The sensitivity is higher than that of flow cytometry, reaching the level of 10-4 to 10-6. The test is relatively easy to be performed in hospital service laboratory. The MRD is represented in a ratio of normalized copy number of the fusion transcript and the control gene transcript (e.g. ABL1). For CML monitoring, an international scale (IS) ratio is developed for standardization of results among different laboratories [4]. Yet, this method is limited to cases with targetable fusion transcripts available for detection.

    b. Allele-specific oligonucleotide (ASO) qPCR for immunoglobulin (IG) or T cell receptor (TCR) gene rearrangement

    ASO qPCR can be employed to detect the disease-specific sequence of rearranged IG gene or TCR gene in the sample. The sensitivity of this method is 10-4 to 10-5. It is applicable to most of the cases of acute lymphoblastic leukemia (ALL) and plasma cell myeloma as long as a disease-specific rearrangement can be determined by sequencing. Patient-specific primers would need to be designed for each case. It has a disadvantage that if there is a clonal evolution, the disease-specific rearrangement can be lost and a false-negative result can be generated.


    4. Digital droplet polymerase chain reaction (ddPCR)

    In ddPCR, the sample is compartmentalized into very large number of separate small volume reactions. As a result, either zero or one target molecule could be detected inside any individual reaction. Thermal cycling would be performed to endpoint using same primer and probes as qPCR. Any target-containing compartments will become brightly fluorescent while compartments without targets will have only background fluorescence. Total number of ‘positive’ reactions is equal to the number of original target molecules in the entire volume, and the total number of reactions multiplied by the individual reaction volume equals the total volume assayed. Therefore, ddPCR provides an absolute quantification of the target molecules. The ddPCR has the advantage of very high sensitivity of ~10-6, does not require a standard curve unlike qPCR, and is tolerant to PCR inhibitors due to small partition volume. The application of ddPCR includes monitoring of NPM1 and ASO IG or TCR gene rearrangement [5,6].


    5. Next generation sequencing (NGS)

    NGS is a robust method to perform multiple sequencing in parallel which can also be used for MRD detection apart from the detection of mutations that are of diagnostic, prognostic and therapeutic importance. For MRD detection, the LymphoTrack platform can be used to detect disease-specific IG or TCR gene rearrangements. The sensitivity of the method can be up to 10-5 or higher [7]. A diagnostic sample would be required for identification of the disease-specific rearrangement. However, this method is also capable of detecting clonal evolution.



    Reference

    1. Schuurhuis GJ, Heuser M, Freeman S, et al. Minimal/measurable residual disease in AML: a consensus document from the European LeukemiaNet MRD Working Party. Blood. 2018 Mar 22;131(12):1275-1291. doi: 10.1182/blood-2017-09-801498.
    2. Baer MR, Stewart CC, Dodge RK, et al. High frequency of immunophenotype changes in acute myeloid leukemia at relapse: implications for residual disease detection (Cancer and Leukemia Group B Study 8361). Blood. 2001 Jun 1;97(11):3574-80. doi: 10.1182/blood.v97.11.3574.
    3. Flores-Montero J, Sanoja-Flores L, Paiva B, et al. Next Generation Flow for highly sensitive and standardized detection of minimal residual disease in multiple myeloma. Leukemia. 2017 Oct;31(10):2094-2103. doi: 10.1038/leu.2017.29.
    4. Hughes T, Deininger M, Hochhaus A, et al. Monitoring CML patients responding to treatment with tyrosine kinase inhibitors: review and recommendations for harmonizing current methodology for detecting BCR-ABL transcripts and kinase domain mutations and for expressing results. Blood. 2006 Jul 1;108(1):28-37. doi: 10.1182/blood-2006-01-0092.
    5. Bill M, Grimm J, Jentzsch M, et al. Digital droplet PCR-based absolute quantification of pre-transplant NPM1 mutation burden predicts relapse in acute myeloid leukemia patients. Ann Hematol. 2018 Oct;97(10):1757-1765. doi: 10.1007/s00277-018-3373-y. Epub 2018 May 22. PMID: 29785446.
    6. Takamatsu H, Wee RK, Zaimoku Y, et al. A comparison of minimal residual disease detection in autografts among ASO-qPCR, droplet digital PCR, and next-generation sequencing in patients with multiple myeloma who underwent autologous stem cell transplantation. Br J Haematol. 2018 Nov;183(4):664-668. doi: 10.1111/bjh.15002. Epub 2017 Dec 22. PMID: 29270982.
    7. Yao Q, Bai Y, Orfao A, Chim CS. Standardized Minimal Residual Disease Detection by Next-Generation Sequencing in Multiple Myeloma. Front Oncol. 2019 Jun 6;9:449. doi: 10.3389/fonc.2019.00449.
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    Sat, 2021-12-18 16:12
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    Year 2021

    Sat, 2021-12-18 11:23

    Volume 30, Issue 1 (click here to download the full pdf version)

    Message from the President

    In this issue of the College Newsletter, I am delighted to announce that Professor Dennis LO, Professor Joseph Sriyal Malik PEIRIS and Professor Kwok Yung YUEN (in the order of their surnames) have received the prestigious Royal Medal of The Royal Society as well as the Future Science Prize 2021 in life sciences for their contributions in the discoveries of cell-free DNA for noninvasive prenatal diagnosis and zoonotic transfer of coronavirus to human causing Severe Acute Respiratory Syndrome (SARS) in 2003, respectively. My heartfelt congratulations!

    Under the new normal of COVID-19, all examinations in 2021 were still conducted using video conferencing technology. I would also like to thank all external and local examiners for their hard work and to congratulate all successful candidates in the College Membership Examination and Fellowship Assessment. They have added new workforce to the diagnostic services in Hong Kong.

    Another issue of postgraduate education under the new normal is how to receive training without a face-to-face arrangement. The Academy recently held a Medical Education Conference to discuss the way forward on e-learning, competency-based training and continuous workplace-based assessment. Both educators and students need to acquire new skills and improve their resilience to training progress.

    Dr Derek HUNG and Professor KY YUEN wrote a Topical Update in this issue of newsletter titled “Diagnosis of COVID-19”. It is a timely topic to review all the diagnostic modalities to combat COVID-19.

    Last but not least, our College, jointly with Academy, has prepared promotional materials for COVID-19 vaccination including posters and videos. They are uploaded to the COVID corner of our College website and Facebook. Please feel free to share them with your friends and family.

    Finally, allow me to wish you all ‘good health’ going forward !


    Dr. CHAN Ho Ming
    President

    October 2021

    Volume 29, Issue 2 (click here to download the full pdf version)

    Message from the President

    In this issue of the College Newsletter, I am delighted to announce that the Genetic and Genomic Pathology (GGPath) Training Programme and all successful First Fellows of GGPath have been fully accredited by The Hong Kong Academy of Medicine and this new specialty has been listed as one of the sixty-three specialties in the Specialist Register of The Medical Council of Hong Kong. Therefore, College would like to remind all concerned Fellows about the proper quotation of this new qualification. Also, I would like to thank the joint effort of all members of GGPath Training Programme Working Group, GGPath First Fellow Assessment Team and the newly established GGPath Specialty Board for their hard work. Hopefully, our College can enroll the first batch of GGPath trainees very soon.

    As President of the College, I participated in Academy of Medicine’s 27th Annual General Meeting held last December. The Sir David Todd Orator 2020 was Professor Francis CHAN with his talk titled ‘Being a Leader’. The Conferment Ceremony was conducted in the Academy Building in a very unusual way due to precautionary measures for COVID-19 with all the Fellowship recipients joining via video conferencing. Each College President announced his/her new Academy Fellows on screen.

    I would like to send my heartfelt congratulations to Dr FOO Ka Chung, our new Distinguished Young Fellow, who also wrote a Topical Update in this issue of newsletter as well as all new Fellows and Members who were successful in College Examinations 2020 conducted via video conferencing during COVID-19 pandemic. I would also take this chance to thank our External Examiners, Chief Examiners, Deputy Chief Examiner and Local Examiners for their tremendous effort in making it possible for the College Examinations to be conducted as scheduled.

    In the Out of the Whitecoat article, Dr LEE Kam Cheong shared with us about his fascinating bird-watching stories.

    Professor Paul CHAN was recently interviewed by ‘PathWay’ of The Royal College of Pathologists of Australasia to share how Hong Kong managed COVID-19.

    Finally, allow me to wish you all ‘good health’ going forward !


    Dr. CHAN Ho Ming
    President

    March 2021

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    • Read more about Year 2021
    Thu, 2021-11-25 15:45

    The Hong Kong College of Pathologists

    27 Nov 2021 9:00 to 12:30

    • Read more about Trainee Presentation Session 2021

    Trainee Presentation Session 2021

    Thu, 2021-11-25 14:09

    Trainee Presentation Session 2021

    Venue: Pao Yue Kong Auditorium, Hong Kong Academy of Medicine Jockey Club Building
    Time: 27 Nov 2021 9:00 - 12:30

    Detail schedule in pdf


    Introduction

    Dr. YAU Tsz Wai Derek

    9:00 - 9:10


    Platform Oral Presentation

    9:10 - 11:30


    2021 TPS Abstract Book in pdf


    Dr. CHIU Hei-Yung Kelvin

    Emergence of Staplyococcus Lugdunensis as a Cause of Urinary Tract Infection: Results of the Routine Use of MALDI-TOF MS


    Dr. SIN Ching-Tai Eugene

    A Risk Stratification Model for Vancomycin-Resistant Enterococcus Colonization Amongst Traced Hospital Contacts


    Dr. LAM Wing-Kit

    MYD88 Mutation in Diffuse Large B-cell Lymphoma: Single Center Study in Hong Kong


    Dr. LAM Ki

    Single sIgE for Dermatophagoides pteronyssinus (Dp) is a Good Screening Tool for Atopic Sensitization


    Dr. HUNG Ling-Yin

    X-Chromosome Inactivation and PCDH19- associated Epileptic Encephalopathy: A Novel PCDH19 variant in a Chinese family


    Dr. TSANG Yat-Ming

    Evaluation of Nanopore-based 16S rDNA Amplicons Sequencing for Detection of Bacteria on Culture-Negative Specimens with Clinical Evidence of Infection


    --- break ---


    Dr. LI Ting-Hon Stanford

    A Retrospective Observational Study On The Red Cell Morphological Changes And Changes In Haematological Parameters Associated With Alectinib


    Dr. FUNG Ching-Ki

    Uterine Sarcoma with MEIS1-NCOA2 fusion - A Case Report and Review of the Literature


    Dr. LI Xin

    Asymptomatic Shedding of SARS-CoV-2 in Conjunctival Secretions


    Poster Presentation

    11:30 - 12:30


    Dr. GAO Yang

    Splenic Littoral Cell Haemangioendothelioma: Case Report

    Download poster in pdf


    Dr. LO Chun-Hai Haison

    A Retrospective Study on Cytogenetic Features and Prognosis of Chinese Myeloma Patients in a Tertiary Referral Centre in Hong Kong

    Download poster in pdf


    Dr. HAU Man-Nga

    Intestinal Ganglioneuromatosis: An Unusual Presenting Feature in MEN2B Syndrome As Acute Toxic Megacolon

    Download poster in pdf


    Dr. WONG Yuen-Sze Sivia

    Microscopic Colitis: Report of Two Cases of Collagenous Colitis

    Download poster in pdf


    Dr. LI Wai-Yan Jamilla

    Langerhans Cell Sarcoma: A Case Report

    Download poster in pdf


    Dr. LEUNG Hoi Shan

    Biotin Interference and Biotin-Depletion Protocol

    Download poster in pdf


    Dr. LI Ting-Hon Stanford

    A Retrospective Study on Cytogenetic Features and Prognosis of Chinese Myeloma Patients in a Tertiary Referral Centre in Hong Kong

    Download poster in pdf


    Judges Meeting and Words from Judges

    12:05 - 12:15


    Prize and Certificates Presentation

    12:15 - 12:30


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    Results of College Exam 2021 (Council Meeting 29 September 2021)

    Wed, 2021-09-29 21:03

    Results of College Exam 2021 (Council Meeting 29 Septmeber 2021)

     

    Fellowship Assessment:

     

    EXAM NO.

    RESULT

    E21201

    PASS

    E21202

    FAIL

    E21203

    FAIL

    E21204

    PASS

    E21205

    PASS

    E21206

    PASS

    E21207

    PASS

    E21208

    PASS

    E21209

    PASS

    E21210

    FAIL

    E21211

    PASS

    E21212

    PASS

    E21213

    PASS

    E21214

    PASS

    E21215

    PASS

    E21216

    PASS

    E21217

    PASS

    E21218

    FAIL

    E21219

    PASS

    E21220

    PASS

    E21221

    PASS

    E21222

    PASS

     

    Membership Examination:

     

    EXAM NO.

    RESULT

    E21101

    FAIL

    E21103

    PASS

    E21104

    PASS

    E21105

    PASS

    E21106

    PASS

    E21107

    FAIL

    E21108

    PASS

    E21109

    PASS

    E21110

    FAIL

    E21111

    FAIL

    E21113

    PASS

    E21114

    PASS

     

     

     

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    • Read more about Results of College Exam 2021 (Council Meeting 29 September 2021)
    Sat, 2021-07-24 14:58
    • Read more about 2019冠狀病毒病疫苗資訊
    Sat, 2021-07-24 14:56
    • Read more about Information related to Covid19-Vaccination for Public

    Information related to Covid19-Vaccination for Public

    Sat, 2021-07-24 14:50

    Information related to Covid19-Vaccination for Public

    2019冠狀病毒病疫苗資訊


    Poster 海報

    Poster 1

    Download Poster 下載海報


    Poster 2

    Download Poster 下載海報


    Poster 3

    Download Poster 下載海報


    Video 視頻

    Video 1

    View video 觀看視頻


    Video 2

    View video 觀看視頻


    Video 3

    View video 觀看視頻


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    Results of College Written Exam 2021 (Council Meeting 22 July 2021)

    Sat, 2021-07-24 11:38

    Results of College Written Exam 2021 in Chemical Pathology, Clinical Microbiology & Infection and Haematology


    CANDIDATE NO.

    RESULT

    E21111

    PASS

    E21114

    PASS

    E21213

    PASS

    E21214

    PASS

    E21215

    PASS

    E21216

    PASS

    E21219

    PASS

    E21220

    PASS


    Passed candidates can proceed further in Fellowship Assessment / Membership Examination in 2021.

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    Trainee Presentation Session 2021

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    Results of College Exam 2021 (Council Meeting 29 September 2021)

    29/09/2021

    Information related to Covid19-Vaccination for Public

    24/07/2021

    Results of College Written Exam 2021 (Council Meeting 22 July 2021)

    24/07/2021
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