1997 AMP MEETING AMP Annual Meeting NOV. 13-15, 1997 (Thurs.-Sat.) Wyndham Emerald Plaza Hotel 400 West Broadway San Diego, California 92101 (800) 626-3988 or (619) 239-4500 (619) 239-3274 (FAX) See below for more details. PRESIDENT'S MESSAGE The best thing about AMP is the dynamic networking whereby members can interact with others who are doing similar work elsewhere. This type of interchange is especially useful in our discipline, because molecular technology is evolving quickly, and there are frequently other people who have already invented the wheel that you are trying to devise. In this regard, a major mission for AMP is to enhance communication. The annual meeting last November in Baltimore was an outstanding forum for sharing ideas and information. After the meeting, many people told me that the AMP meeting is their favorite scientific meeting because of its interactive nature. We will strive to keep our annual meetings practical and informal, even as our membership grows in number, so that we always maintain opportunities for questions and group discussion. Interactive communication extends year-round through the CHAMP listserv. For those not previously inclined to use a keyboard, I encourage you to improve your computer literacy so that you can enjoy the larger world that e-mail and the Internet brings to your doorstep. Send e-mail messages to the group through CHAMP@path.upmc.edu and also remember to check out the AMP homepage at http://www.pds.med.umich.edu/users/amp. Do you ever wonder which of your AMP colleagues is doing which molecular tests? Thanks to the recently compiled AMP Test Directory, you can find out. And by using the AMP Membership Directory, you can find their address, phone, fax and e-mail address. In the coming year, we hope to make progress on yet another avenue of communication, namely affiliation with a journal through which we can publish our abstracts and announcements, and reach out to the larger medical community. It is important that we continue to expand our communication capabilities, for the benefit of each individual member and for the collective discipline of molecular pathology. Contributed by Peggy Gulley, MD AMP President Department of Pathology University of Texas Health Sciences Center San Antonio, TX gulleym@uthscsa.edu 1997 ANNUAL MEETING San Diego '97 The 1997 AMP meeting will be held at the Wyndham Emerald Plaza Hotel in San Diego, California, November 13-15. The meeting will begin on Thursday this year, rather than Friday, and will end with a social event on Saturday night so that attendees from the East Coast will be able to catch early flights the following morning and be home by Sunday night. The Wyndham Hotel is in downtown San Diego, with numerous restaurants and shops close by, and is an elegant hotel with excellent meeting accommodations. There are no conflicting meetings in the hotel; we have reserved all of the meeting space during the time of our meeting. The hotel will extend the meeting rate of $125 per night for 3 days prior to and after the meeting, to accommodate those who plan to attend the AACC SD Conference on Nucleic Acids meeting the previous weekend or who wish to pursue vacation plans. Program planning is underway now for the 1997 meeting. Members of the Program Committee will be working to finalize the 1997 program by late March. Input from anyone is welcome, AMP member or not. If you have comments or suggestions for 1997 program topics, please contact Dr. Braziel or another Program Committee member as soon as possible. Dr. David Cooper will be helping with recruitment of exhibitors for the meeting again this year. Dr. Carleton Garrett, Program Chair Elect, is now working to identify the meeting site for the 1998 AMP meeting. This meeting will be held somewhere in the Eastern United States. If you are interested in hosting the 1998 AMP meeting, please contact Dr. Garrett for hotel and meeting specifications. Rita Braziel, MD, Program Chair: (503) 494-2315/FAX (503) 494-0731 Carleton Garrett, MD, Prog. Chair-Elect: (804) 828-9749/FAX (804) 828-9564 ctgarrett@gems.vcu.edu Contributed by Rita M. Braziel, MD Oregon Health Science University braziel@ohsu.edu Maricel Herrera, Meetings Coordinator, UAREP/APC/AMP THE 1996 ANNUAL MEETING The second Annual Meeting of the Association for Molecular Pathology was held November 15-17 at the Omni Inner Harbor Hotel, Baltimore, MD. There were over 30 speakers at plenary sessions and workshops, and over a dozen commercial exhibitors. The conference facilities were generally good, although we did not expect such a high level of demand for space in the commercial exhibits area. Sixty-six posters were presented by attendees, several of whom were from abroad; some came from as far away as South Africa. The rapid growth in attendance at the meeting would seem to bode well for the future of AMP. Even with the best planning there always seems to be the odd thing that's overlooked. This year it was thumb-tacks for the posters! Thanks to Tim O'Leary for accompanying me to the local Kinko's to purchase 600 of these at 9PM the night before the conference began! The Program Committee was greatly assisted in the selection of speakers by the members of the various Sections of the Association. We were also fortunate that so many excellent speakers were available in the vicinity of the conference. The general feedback on the meeting was very positive and the continued success of the annual meeting firmly places AMP as the leading national organization for molecular pathology. One of the highlights of the meeting for many people is the chance to meet others working in molecular pathology laboratories. Many of us only have the opportunity to meet each other once a year. These social and scientific interactions are invaluable. They provide a perspective on the scope of molecular diagnostic activities nationally, serve as opportunities to discuss test and sample sharing, and are a means keep abreast of new developments. The Saturday evening dinner at the B & O Railroad Museum (organized by Jeff Kant and Fran Pitlick) was a memorable event in a wonderful setting. It has been a privilege to serve as Chair of the Program Committee. I would like to express my gratitude to the members of the Committee: Rita Braziel, Diane Farhi, Ron McGlennen, Rick Nolte, Steve Thibodeau, Tom Traweek, Karl Voelkerding, Linda Wasserman, and Sandy Wolman. In addition, the work of the local organizers, Fran Pitlick and Maricel Herrera, was invaluable. Contributed by: Tony Killeen, MD, PhD 1996 Program Chair University of Michigan, Ann Arbor akilleen@umich.edu 1997 CPT CODE INFORMATION [Ed. note: Thanks to Karen Kaul for providing this information]. In the December 1996 issue of Medicare Part A News, the following was reported. Several new lab CPT codes were added for 1997. A relevant one for readers of this Newsletter is: 83902: Molecular diagnostics; reverse transcription In 1996, the description for code 83898 was, “nuclear molecular diagnostics; nucleic acid probe with amplification, e.g. PCR, each”. In 1997, 83898 has been revised to remove the probe portion; 83898 is now properly used for amplification only. The fee amount for 83898 should reflect removal of the probe. Use 83896 to report each use of a probe. This information was also published in the December 11, 1996 issue of CAP's STATLINE. UPDATE ON ETHICAL ISSUES The new Congress will be addressing several issues related to the ethical use of medical and genetic information. In the previous legislative session, Senator Pete Domenici (R-NM) introduced "The Genetic Confidentiality and Nondiscrimination Act of 1996", S. 1898. His staff has been reworking the bill to address some of the concerns of both geneticists and pathologists before re-introducing the bill in the new Congressional session. We have had the opportunity to discuss our concerns and make recommendations, and are waiting for the next draft for comment. In addition to action in Congress, the Executive Branch of the Federal Government is also addressing several ethical issues through the President's newly formed National Bioethics Advisory Commission. A Human Subjects Subcommittee and a Genetics Subcommittee have been formed and each subcommittee met in December, 1996 to set up an agenda of items to consider such as informed consent, definitions of genetic tests and information, etc. We will be following these deliberations closely. Contributed by: Mark Sobel, MD, PhD Secretary-Treasurer Chair, Publications Committee Laboratory of Pathology National Cancer Institute molpath@helix.nih.gov CERTIFICATION The American Board of Bioanalysis (ABB) is located at 917 Locust Street, Suite 1100, St. Louis, MO 63101-1413; ( (314) 241-1445; FAX (314) 241-1449. ABB administers certification examinations in several disciplines and recently “Clinical Molecular Biology” was added to this list. Contact ABB to learn more about requirements to apply for sitting for the examination or refer to the October 1996 AMP Newsletter. The next exam is May 4, 1997 (Houston). To sit for that exam your application must be submitted for processing no later than March 7, 1997. The National Certification Agency (NCA) will offer an examination this summer. Those who pass the exam will be certified as a clinical laboratory specialist in molecular biology: CLSp (MB). The test is designed for medical technologists but that doesn’t mean that anyone qualified can’t take it. Contact Dr. Kathy Doig (doig@pilot.msu.edu) or NCA (913-438-5110) to learn more about eligibility, dates, fees, content outlines, etc. Contact Ms. Jane Pritchard if you are interested in writing/reviewing/editing examination questions (there may be something in it for you). Jane is at (918) 628-6363 in Tulsa (FAX, 918-664-0596). Contributed by Dan Farkas, PhD, HCLD Editor, AMP Newsletter Molecular Probe Lab, Wm. Beaumont Hospital dfarkas@beaumont.edu PUBLICATIONS COMMITTEE As 1997 begins, Dr. Cheryl Willman is rotating off the Publications Committee. Dr. Tom Frank and Dr. Sandra Wolman remain on the Committee and will be joined by Dr. Mark Lovell and Dr. Jeffrey Medeiros. Dr. Dan Farkas, the editor of the AMP Newsletter, and Dr. Tony Killeen, the manager of the AMP home page, are ad hoc members. The Publications Committee will be concentrating its efforts this year on (1) setting up guidelines for home pages for the AMP subdivisions, (2) collating AMP logo submissions to make recommendations to the Council, and (3) helping to carry out the decisions of the AMP ad hoc committee on journal affiliation. Contributed by: Mark E. Sobel, MD, PhD JOURNAL AFFILIATION COMMITTEE AMP is exploring journal affiliation for the purposes of publishing the abstracts from our annual meeting, offering a journal subscription as a benefit of membership in our organization, and providing a forum for publication of articles of interest to our members. We are currently considering six different journals including four general pathology journals and two molecular subspecialty journals. A poll of regular AMP members taken last fall revealed strong interest in receiving a journal subscription as a benefit of AMP membership, with preference expressed for a subspecialty journal over a general pathology journal. Following a discussion of this issue during the business meeting at the 1996 annual meeting in Baltimore, the AMP Council realized that one of the options that had not been previously considered was a general pathology journal that would be willing to provide a subsection for molecular pathology. The AMP Council therefore recommended that we continue to gather information from all six journals before making any decisions, and that process is ongoing. Any member wishing to express their viewpoint on the choice of journal, or on whether subscriptions should be automatic or optional benefits of membership, is welcome to contact a member of the Committee. AMP Journal Affiliation Committee: Peggy Gulley (chair), Rita Braziel, Tony Killeen, Tom Williams Contributed by Peggy Gulley, MD CLINICAL PRACTICE COMMITTEE As the new year begins, the Clinical Practice (CP) Committee is organizing and prioritizing its agenda for 1997. The new AMP Clinical Practice committee consists of Rick Press (chair), Rob Wilson (genetics), Adam Bagg (heme-path), Rick Nolte (ID), Sid Finkelstein (solid tumors), and Debra Leonard (ad hoc “guru”). Many thanks to the 1996 CP committee for their fine work. Their accomplishments will stand as a lofty yardstick by which our new committee will be measured. The following agenda, although preliminary and perhaps too ambitious, stems from a "consensus" reached by conversations with committee members and others at our recent annual meeting, as well as from responses to my Internet appeal for agenda ideas. The coming year will then likely see some progress towards the following goals: 1. The production of "position papers" detailing our views as to guidelines for the clinical utility of specific molecular tests, perhaps two from each of our four subsections. We will likely begin with the tests performed most frequently by our member labs. These practice guidelines will likely address such issues as: · a. “pros” & “cons” of the molecular vs. the "traditional" test (analytical performance, cost, complexity, etc.); what is the gold standard and why? · b. the clinical scenarios for which this test might be useful, i.e., how should it be used? · c. the different methods for performing this test (reagents, suppliers, primers, probes, etc.); which (if any) are preferred and why? · d. interpretation guidelines: what does a particular laboratory result mean clinically? When is the test uninterpretable? · e. turn-around time · f. proficiency standards (availability, frequency, performance) 2. Standardization of test names: what is the preferred name for a test? (so that we can all be talking one language, at least as far as the names of the tests that we perform.) 3. Proficiency: how do we ensure that our tests are performing satisfactorily? Are proficiency materials available? Commercially? If not, from whom? What is the quality and availability of the proficiency material? How often need proficiency be addressed? In what manner? What constitutes adequate performance? With CAP's significant experience and expertise in the proficiency arena, we may look to collaborate with the CAP's Molecular Pathology Resource Committee to accelerate progress in this crucial area. 4. Reimbursement. How well are we recovering our charges? How can we improve this? What regulations apply (federal and/or state)? On that note, I wish you best wishes for a fun and productive 1997. Contributed by: Rick Press MD, PhD, Chair, Clin. Prac. Committee Director of Molecular Pathology Oregon Health Sciences University pressr@ohsu.edu TRAINING AND EDUCATION COMMITTEE The Education and Training Committee has mailed its survey of molecular pathology education to all US residency programs. The survey was supported by the program directors' coordinating committee (PRODS) with a letter of introduction to each program. The purpose of the survey is to gain information about approaches around the country to molecular pathology education for both residents and fellows. The information we receive will be useful as our Committee discusses AMP’s role as a resource for molecular pathology education. We will share a summary of the data from the survey in a future newsletter. As directors of molecular pathology rotations and fellowships, several AMP members are likely to be asked by residency directors at their institutions to complete the survey. We encourage your participation in this activity! Contributed by: Thomas M. Williams, MD Chair, Training and Educ. Committee Univ. of New Mexico School of Medicine williams@medusa.unm.edu HEMATOPATHOLOGY SUBSECTION A warm hello to past and new subscribers to the AMP newsletter. The hematopathology subsection had an excellent program at the November, 1996 meeting in Baltimore, thanks to the efforts of the heme-path committee chairman, Dr. Tom Traweek. We look forward to another stimulating series of plenary talks and workshops this fall in San Diego. I welcome your ideas for these sessions. My own inclination is to highlight the growing convergence of several technologies: PCR, flow cytometry, ISH, and cytogenetics. Does our constituency find this of interest? E-mail me at dfarhi@emory.edu or fax (404) 712-4140. As we are still a young and somewhat freewheeling organization, let me know if you are interested not only in certain topics, but also in suggesting discussion leaders (moderators) for workshops. A note on other heme-path meetings: the Society for Hematopathology (SHP) and the European Association of Hematopathology will conduct their first joint meeting in conjunction with the USCAP meeting in Orlando on Saturday, March 1, 1997; the topic is "Clinical translations from hematopathology"; the speakers are distinguished hematopathologists from the US, Germany, and the UK. The SHP is also conducting its regular USCAP seminar on Sunday afternoon, March 2; the topic is "the WHO classification of lymphomas"; for more information call the USCAP at (706) 733-7550. The SHP will conduct a half-day workshop at the Fall ASCP meeting in Philadelphia, September 20, 1997 (topic and speakers not yet announced); for more information call the ASCP at (312) 738-1336. Thanks for your attention. Contributed by: Diane Farhi, MD Department of Clinical Pathology Emory University Hospital Atlanta, GA dfarhi@emory.edu GENETICS SUBSECTION The Genetic Session of the 1996 AMP meeting in Baltimore was a great success; 18 abstracts were submitted, representing 17 different American and international institutions. The organizing committee was impressed with the quality as well of the breadth and depth of the poster presentations. AMP is dedicated to a high level of representation by its members, and the participants in the Genetic session oral platforms of the abstracts can be proud of the importance of their work. Genetic Session Plenary Presentations The 1996 Genetics plenary presentations focused on two areas of extraordinary success in basic genetic research. The challenge to the organizing committee to define topics with an appeal to the general practitioner of molecular diagnostics, and yet ones which carry excitement and anticipation of discovery in basic research were fulfilled with this years speakers. Professor Harry Orr from the University of Minnesota presented a perspective on trinucleotide repeat syndromes with an emphasis on a disease he has helped to characterize, spinocerebellar ataxia type 1. Dr. Orr reviewed the short history of discovery of diseases associated with genes harboring unstable trinucleotide repeats. These disorders include the better understood syndromes such as Fragile X, myotonic dystrophy and Huntington disease and a list of approximately 7 others. Whereas instability of the size of the trinucleotide repeat alleles are at the heart of the genetic nature of these diseases, the pathophysiology of each may be highly unique and diverse. Drawing upon his experience in the discovery of Ataxin 1, Dr. Orr and his group have subsequently moved on to the development of an animal model system which recapitulates the human disease. Several lines of transgenic mice harboring an expanded form of the ataxin allele developed overt signs of ataxia, which pathologically showed a loss, as well as an abnormal migration, of the Purkinje cells from their normal location within the cerebellum. Ongoing studies are attempting to better understand the cellular changes linked with the progressive loss of these neurons. One of the goals of AMP and of the Genetics section organizing committee in planning the genetics session is to embrace the discipline of molecular diagnostics in its broadest sense. The second plenary speaker, Professor David Ledbetter from the University of Chicago presented an elegant demonstration of how far fluorescent in situ hybridization (FISH) technology has come, and how central its role as a front-line diagnostic tool for inherited and acquired disorders it is. FISH employs fluorescently labeled probes to chromosomes in situ, whether in cell cultured and processed for metaphase analysis, or within the context of the cell as interphase preparations. According to Dr. Ledbetter, one great advantage of FISH technology is in the diagnosis of occult or submicroscopic chromosomal translocations. To that end, Dr. Ledbetter’s group has recently succeeded in developing a complete complement of FISH probes to the human chromosome telomeres. This accomplishment was presented in vivid living color, where his library of telomeric markers were prepared in a cocktail and hybridized resulting in a full human idiogram. In addition to the esthetic appeal of these reagents, Dr. Ledbetter shared his experience with several amazing cases, in which conventional cytogenetic banding techniques as well as other DNA based analyses, failed to show what FISH could show. The message from that fascinating lecture was clear: FISH is a vital part of the complete molecular genetic testing service. Genetic Session Workshops The 1996 AMP meeting was the second year where the Genetic section offered a practicum workshop dealing with the essential skills for the diagnostic molecular geneticist. The purpose of these workshops has been to refresh the practitioner of the important tools used by clinical and population geneticists, as well as those employed by research scientists working in the area of new gene discovery. The focus of this practicum at the Minneapolis meeting (1995) was a review of problems in Bayesian Analysis. In 1996, Dr. Daniel Staid, from the Mayo Clinic in Rochester, Minnesota humbled us with an excellent presentation of the tools and approaches of linkage analysis for new gene discovery and routine diagnostics. The workshop was very well attended, and during the 2 hours, Dr. Schaid worked through a series of basic and difficult problems, any one of which might confront us in our daily work. 1996 was also the second year for the New Technologies workshop. Perhaps nowhere else in the field of medicine and technology is the pace of change so great as it is in molecular diagnostics. Whether in the continuous development of new recombinant enzymes for biochemical reactions or in the introduction of exciting new pieces of automated instrumentation, it is amazing how much new technology is changing the types of diseases we can study, the cost of performing these assays and even the manner in which we make the diagnosis. Two speakers presented in the 1996 workshop, which was dedicated to the “not so distant future” of the field of molecular diagnostics. Dr. Allen Northrup (Lawrence Berkeley Laboratories-LBL) has been a pioneer in the area of microelectromechanical systems (MEMS) research. To that end, Dr. Northrup has also led the charge to employ the exciting promise of microminiaturization of clinical lab testing onto silicon. In his presentation he outlined the program leading to the development of a the microchip based thermocycler and laptop computer completely contained in a small briefcase. This exciting package was recently delivered to the Armed Forces Institute of Pathology for field testing. The prospect for real time detection of amplified DNA product based on the TaqMan technology was also demonstrated, where a tiny CCD detector chip is assembled into the amplification reaction chamber. The prospect for an integrated DNA testing system was also displayed, which involves the LBL thermocycler chip coupled to a microfabricated capillary electrophoresis unit. Overall, Dr. Northrup emphasized that many of these technologic advances are still 5-10 years from commercial availability, but based on the number of centers involved in this exciting work, it’s likely to be here much sooner than that. An exciting look into the workings of a truly state of the art, high throughput DNA sequencing operation was offered by Dr. Jay Lichter (Sequana Therapeutics), the second presentation in the New Technologies session. Dr. Lichter is the leading scientist at Sequana, dedicated to automated linkage analysis and new gene discovery leading ultimately to new therapeutics. Rows and rows of automated DNA sequencers linked to dozens of Macintosh computers are the weapons needed to crunch the vast amount of data needed to find a single gene. Sequana is pioneering the effort to use microsatellites in linkage analyses to find loci that associate with complex or polygenic disorders e.g., diabetes or certain inflammatory states. One fascinating success story for Sequana is the journey that had led Dr. Lichter and his team to a remote island in the Atlantic in search of a gene involved in asthma. The ability to process such a huge volume of samples and the scores of markers required to find Wheeze 1 demonstrates the progress companies such as Sequana and the Human Genome Project, in general, have made. By contrast, however, those of us back in the clinical labs using molecular genetics every day to solve problems for patient care can be assured that the rate of new genetic discoveries is not likely to slow, and thus nor will our work. Looking Forward to the Next AMP Meeting The 1996 AMP meeting was another testament to the growing importance of molecular diagnostics in modern medical practice. On behalf of those involved in the 1996 meeting, I extend a hearty thanks to the invited plenary speakers and the workshop faculty; all of your efforts were excellent and greatly appreciated. The 1997 organizing committee for the Genetic Session will soon be back at work planning for the AMP meeting in San Diego. It’s difficult to predict what will be the important discoveries and the new innovations of 1997, but the goal of the 1997 meeting is to continue to keep AMP members at the forefront of where molecular diagnostics is going. Keep in touch. Contributed by: Ronald C. McGlennen, MD University of Minnesota Hospital and Clinic mcgle001@tc.umn.edu AMP MEETING 1996 - A SOUTH AFRICAN PERSPECTIVE I arrived in Baltimore round about midnight (& exhausted!) the evening before the AMP meeting and spent the night at a hotel near the BWI airport. The fourteen and a half hour flight from Cape Town to Miami plus an additional two hours onto Baltimore caused me to oversleep, resulting in a mad rush to get to the Omni Hotel the next morning. I was relieved to finally meet up with my (worried) colleague, Mark Engel, in the hotel foyer - Mark came via London. The long haul to get to the AMP meeting was certainly well worth it. I finally got to meet some of the names I have only seen or "chatted" with on e-mail before, and also managed to network several colleagues from the USA and Europe. This was our first opportunity to attend a conference abroad - such chances were not easily given before, because of us having the "wrong" colour in "Apartheid-South Africa". It was a refreshing and stimulating experience (being rather isolated at the tip of Africa), and some memories include discussions with fellow AMP members, sharing PCR woes, making new friends, listening to some excellent talks, etc. Then of course, how could I forget the wonderful dinner at the Rail Road Museum, although we could not always follow the satirical sendups on stage! Thank you AMP for a well-organized meeting and we hope to see you in San Diego. Contributed by: Faadiel Essop, PhD Molecular Pathology Section University of Cape Town Medical School mfessop@chempath.uct.ac.za HUMAN GENOME NEWS The most recent issue of Human Genome News is on the Human Genome Management Information System WWW site: http://www.ornl.gov/hgmis/publicat/hgn/v8n2/01tocont.html Human Genome News is sponsored by the Department of Energy Human Genome Program, Dr. Aristides Patrinos, Director. 1997 AMP OFFICERS Nominating Committee: President: Peggy Gulley President-elect: Cheryl Willman Past President: Jeff Kant Secretary-Treasurer: Mark Sobel Program Committee Chair: Rita Braziel Prog. Committee Chair-Elect: Carleton Garrett Clinical Practice Committee Chair: Rick Press Training & Educ. Comm. Chair: Tom Williams Publications Committee Chair: Mark Sobel Genetics Chair: Ron McGlennen Genetics Chair-Elect: Robert Jenkins Genetics Nominating Committee Reps: Harry Orr/Cindy Vnencak-Jones Genetics Clinical Practice Rep: Rob Wilson Gen. Training/Educ. Rep: Vickie Matthias-Hagan Hematopathology Chair: Diane Fahri Hematopathology Chair-Elect: Tim O'Leary Hematopath. Nominating Comm. Reps: Karen Chang/Arnold Gelb Hematopath. Training/Educ. Rep: Domnita Crisan Hematopath. Clin. Practice Rep: Adam Bagg Infectious Disease (ID) Chair: Rick Nolte ID Chair-Elect: Roberta Madej ID Nominating Comm. Reps: Barbara Griffith & Helen Fernandes ID Clinical Practice Rep: Rick Nolte ID Training & Educ. Rep: Steve Dumler Solid Tumor Chair: Sandra Wolman Solid Tumor Chair-Elect: Tom Frank Solid Tumor Nominating Comm. Reps: Meera Hameed/Ninette Robbins Solid Tumor Clin. Prac. Rep: Sidney Finkelstein Solid Tumor Training/Educ.Rep: Louis Fink Administrator: Fran Pitlick Secretary: Maricel Herrera AMP Newsletter Editor: Dan Farkas