Sysmex 2Nd International Scientific Seminar, Ho Chi Minh City, Vietnam

Sysmex Journal International Vol. 20 No. 1 (2010) GreatGreat GatheringGathering ofof GreatGreat MindsMinds - Sysmex 2nd International Scientific Seminar, Ho Chi Minh City, Vietnam - Hwee Lee KHOR, Joanna ZHOU Sysmex Asia Pacific Pte Ltd. On the sunny morning of December 11, 2009, Sysmex The seminar was opened by Mr. Mark Hayashi, Asia Pacific, in collaboration with Sysmex Corporation, Executive Officer Managing Director of Sysmex kicked- off its 2nd International Scientific Seminar at the Corporation and Mr. Frank Buescher, President & CEO Sheraton Saigon Hotel & Towers in Ho Chi Minh City, of Sysmex Asia Pacific. Ten speakers from across four Vietnam. continents and more than 300 delegates from 14 countries worldwide (mainly from the Asia Pacific Vietnam is one of the fastest growing countries in Asia, region) attended this important event - the biggest and Ho Chi Minh City, the largest city in Vietnam, is the scientific event organized by Sysmex in Asia Pacific. centre of economic activity. Ho Chi Minh City, also known as Saigon, was very much influenced by the The seminar was divided into three sessions, over one French during the colonial era in the 19th century, which and a half days. The clinical utility of novel parameters is the reason for the number of historic French colonial and approaches in diagnosing diseases were discussed at buildings in the city. Because of this Saigon is also called the first session: "State of the Art". In the second session: "Paris in the Orient". It was very meaningful to present "Defining Disease States", the diagnostic potential of exciting new developments and concepts in this combining data from hematological measurements was transitioning city in the midst of such an historical explored; and during the third session: "Diagnostic atmosphere. Morphology/Cellular analysis", the power of technology in cell analysis was discussed. Notre Dame Cathedral. Ho Chi Minh City was named in honor of the late communist leader, Mr Ho Chi Minh (in the framed picture). − 1 − Sysmex Journal International Vol. 20 No. 1 (2010) Session I: State of the Art Thrombocytopenia is a commonly encountered hematological abnormality, and evaluation of the The first session of the seminar was chaired by Associate mechanism of thrombocytopenia is always necessary for Professor Tien Sim Leng, Senior Consultant determining appropriate treatment. Bone marrow Hematologist at the Department of Hematology and examination has been useful in examining patients with Pathology at Singapore General Hospital. unexplained thrombocytopenia and risk of major bleeding, however it carries a certain level of risk since it Dr. Jo Linssen, Assistant Director and Head of Clinical is an invasive procedure. Less invasive laboratory tests Management Concepts Department at Sysmex Europe are preferred. Professor Yutaka Yatomi, Professor and GmbH, was the first speaker for this session. Dr. Linssen Head of the Department of Clinical Laboratory Medicine, who has a doctor degree in Medical Bio-science has a Graduate School of Medicine at the University of Tokyo, special interest in the differentiation and management of discussed two "non-invasive" and promising laboratory inflammatory diseases. Biochemical markers used to tests; immature platelet fraction (IPF) and diagnose inflammatory diseases are relatively insensitive thrombopoietin (TPO) in "Diagnosis of and expensive, and current clinical scoring systems used thrombocytopenia: a novel approach". Immature for sepsis staging are time consuming and have poor platelets, also known as reticulated platelets, possess inter-observer reliability. Their use in supporting increased RNA content. Measurement of the RNA physicians in diagnosis and identification of patients at content with thiazole orange dye by flow cytometry has risk is limited. The main cause of most of the detrimental been useful in monitoring the thrombopoietic activity and sepsis consequences can be found in impaired or evaluating the diagnostic classification of deregulated function of blood cells so there could be a thrombocytopenia. Prof. Yatomi discussed an automated possibility of developing a score based on routine blood method for quantifying reticulated platelets, expressed as cell parameters to discriminate between infectious and immature platelet fraction, on Sysmex hematology non-infectious inflammatory disease as well as provide a analyzers. He presented study results which showed that prognosis for the disease. immature platelet fraction is a useful parameter for differentiating the causes of thrombocytopenia. He also Dr. Linssen provided an insight to this topic with his showed that serum TPO reflects in-vivo platelet turnover. presentation: "Intensive care management - Thus, both IPF and TPO are useful for learning in-vivo Hematological cell analysis scores for sepsis diagnostics. platelet kinetics and in differentiating the pathogenesis of Imagination or reality?" He concluded that rapid, simple thrombocytopenia. and uncomplicated cellular hematology scores could support treating physicians in identifying patients at high A working group was set up by the Subcommittee on risk and defining the course and severity of the disease. Lupus Anticoagulants (LA) / Phospholipid-dependent The new Sysmex logo mark was used as the backdrop Seminar registration: most of the delegates arrived early during the seminar. to collect the seminar material. − 2 − Sysmex Journal International Vol. 20 No. 1 (2010) antibodies of the International Society on Thrombosis improve patient outcomes. The current film review rules, and Hemostasis (ISTH). This group recently issued new that the laboratory uses for detecting possible guidelines for detecting LA. The new guidelines are myelodysplasia consist of 4 multiple cytopenia rules, and intended to update the guidelines issued in 1995 based on are non-specific. Often a large number of blood films the experience and knowledge accumulated since then. have to be reviewed but only very few cases of MDS are This is the first occasion that Professor Armando detected. Neut-X is a measure of the internal complexity Tripodi, Professor of Laboratory Medicine at the Angelo of neutrophils, in particular, it reflects the cytoplasmic Bianchi Bonomi Hemophilia and Thrombosis Center, granularity of neutrophils. In this study, a Neut-X Internal Medicine, University of Milano and part of the reference range, 1248-1360, was established with 9,232 working group, presented these new guidelines to an patients. Mr. Johnson showed that using a Neut-X at a international audience. In his presentation, Prof. Tripodi cut-off value of <1220 in conjunction with cytopenia of touched on the important issues in LA testing which any degree gave an acceptable film review rate and did include: who should be tested, pre-analytical variables, not miss any patients of immediate clinical significance. which test(s) should be performed, diagnostic criteria, With this, he has foreseen that the laboratory's film when to do the test, and results reporting. review rate will drop by 1.1% or 176 films per month from the current rate while not missing any clinically significant cases and improving detection in patients who Session II: Defining Disease States presented with a single borderline cytopenia. The second session of the seminar was chaired by Dr. Shanaz Khodaiji, Consultant of the Department of Professor Yukio Ozaki of the Department of Clinical and Hematology and Transfusion Medicine of P.D. Hinduja Laboratory Medicine of the University of Yamanashi in National Hospital and Medical Research Centre in Japan explained the fundamentals of hematology, Mumbai, India. focusing on red blood cells in his presentation, titled "Clinical significance of new RBC-related parameters of The first presenter for this session was Mr. Steve automated hematology analyzers". With the advancement Johnson, charge scientist of the Hematology Laboratory of technology, cells such as nucleated red cells and at Medlab Central in New Zealand. In his presentation, fragmented red cells can now be precisely counted. he described the use of yet another innovative parameter, Reticulocyte hemoglobin (Ret-He) has been found to be a Neut-X, by Sysmex hematology analyzers to detect early superior parameter over conventional parameters such as myelodysplastic syndromes (MDS). Treatments for MDS serum iron, transferrin, ferritin or transferrin saturation are mostly supportive. However, with new treatments which can be disturbed during inflammation, pregnancy available, it is desirable to detect MDS early so as to and many severe diseases. Its use in diagnosing Delegates from Thailand taking a group picture Interesting questions and animated discussions during the tea break. during the seminar. − 3 − Sysmex Journal International Vol. 20 No. 1 (2010) functional iron deficiency has become a focus of interest. disease, especially acute leukemia. Dr. Khanh concluded In his presentation, Prof. Ozaki explained the Sysmex that D-dimer, prothrombin time, fibrinogen and platelet technologies for measuring these new RBC-related count are the most important tests for investigating DIC, parameters. and treatment for DIC is effective only if given in combination with treatment for the underlying disease. The last two talks in the second session were presented by speakers from the host country. Both speakers shared issues and challenges facing Vietnam. Dr. Pham Quang Session III: Diagnostic Morphology/ Vinh, Vice Director of the National Institute of Cellular Analysis Hematology

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