Program Booklet 1st MSLH Scientific Meeting 2011 & Morphology Workshop

Haematology Morphology Workshop

1ST MALAYSIAN SOCIETY OF LABORATORY HAEMATOLOGY

SCIENTIFIC MEETING 2011

28th - 30th September 2011New Pacific Hotel, Kota Bharu, Kelantan

Organized by: Members of Malaysian Laboratory Haematology Society (MMLHS)Supported by: Universiti Sains Malaysia (USM)

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1st Malaysian Society of Laboratory Haematology Scientific Meeting 2011 3

CONTENTSPage Contents

Welcome Address4 Organizing Chairperson5 MMLHS President

6 Floor Plan - Venue & Exhibition

7 Steering Committee

8-10 Agenda

11-20 Speakers

21-22 Corporate Talk

23 Lunch Talk

24-32 Plenary Talk

33-36 Entrant Registers

34 Sponsors

38 Appreciation

4 1st Malaysian Society of Laboratory Haematology Scientific Meeting 2011

Dear colleagues, On behalf of the organizing committee, I would like to extend the warmest welcome to all of you to Kota Bharu, Kelantan and Morphology Workshop. The combination of an outstanding location with an equally exciting scientific program augurs well for a stimulating workshop. I would like to take this opportunity to publically thank the Members of Malaysian Laboratory Haematology Society (MMLHS) for giving the honor to us to organize the first educational event.

The workshop will showcase many current updates in the field of major area in haematomorphology that include the latest classification on myeloid and lymphoid neoplasm followed by case studies shared by local and international speakers.

We are honored to offer an outstanding and inspiring speakers including Emeritus Professor Cheong Soon Keng, Professor Han Kyung-Ja, Associate Prof Surender Juneja and Assoc Prof Narazah Mohd Yusoff. I would also like to thanks all individual responsible for the success of this workshop, the organizing committee and all our exhibitors who contribute generously to the corporate talk and lunch-hour CME session to make this truly the best morphology workshop meeting. We encourage all participants to visit the exhibits to update on the innovations the exhibitors offer.

WELCOME ADDRESSBY ORGANIZING CHAIRPERSONASSOCIATE PROF. DR. ROSLINE HASSAN


WELCOME ADDRESSBY MMLHS PRESIDENT

ASSOCIATE PROF. DR. NARAZAH MOHD YUSOFF

Dear colleagues and friends,

The Members of Malaysian Laboratory Haematology Society (MMLHS) has great pleasure in welcoming you to the 1st MALAYSIAN SOCIETY OF LABORATORY HAEMATOLOGY SCIENTIFIC MEETING 2011 and Haematology Morphology Workshop to be held on 28th to 30th September 2011 in Kota Bharu, Kelantan.

This meeting and workshop will be the first event organised by this society (MMLHS) where internationally renowned speakers will share their experience and invaluable insights. We will be introduced to the current state of knowledge on haematomorphology and the latest advancement and technologies in haematology.

I would like to take this opportunity to say thank you to all the speakers, members of the organising committee and society and those who have supported us.

A special thank you to the companies which present their innovative products, technologies and services in our industrial exhibition. We look forward to seeing you in Kota Bharu.

!


FLOOR PLANVENUE & EXHIBITIONS

LAYOUT LEGEND:Participant TableRoom PillarMorphology Quiz Area

Exhibition BoothDining AreaVIP Dining Area

Elevator

EXHIBITION BOOTH LIST1.Scientech Medical Sdn. Bhd2. -3. -4. -5.Abbot Laboratories M Sdn Bhd

6.Straits Scientific (3S) M Sdn Bhd7. Fresenius Kabi M Sdn Bhd8. DPC Healthcare Sdn Bhd9. All Eights M Sdn Bhd10.Sysmex M Sdn Bhd


STEERING COMMITTEE1ST MALAYSIAN SOCIETY OF LABORATORY HAEMATOLOGY

SCIENTIFIC MEETING 2011“HAEMATOLOGY MORPHOLOGY WORKSHOP”

PATRON & ADVISER

CHAIRPERSON

VICE CHAIRPERSON

SECRETARY

TREASURY

SECRETARIAT

HOSPITALITY

PUBLICITY & SPONSORSHIP

TECHNICAL & AVA

MORPHOLOGY QUIZ

Prof. Madya Dr. Narazah Mohd Yusoff

Prof. Madya Dr. Rosline Hassan

Prof. Madya Dr. Wan Zaidah Abdullah

Ahmad Zakwan Mustafa

Dr. Salfarina Iberahim

Wan Soriany Wan Md ZainSelamah Ghazali, Norleha Mohd Noor

Khairiah Yazid, Narishah Sharif

Norizah Tumin, Maseta Ismail Rohani Bakar, Lim Seng Hock Dr. Wan Haslindawani Wan Mahmood

Nik Mohd Fariz Nik Zahari Noor Azmizam Abdul Rahman

Prof. Madya Dr. Wan Zaidah AbdullahDr. Wan Haslindawani Wan MahmoodAng Cheng Yong


AGENDADAY 1: 28TH SEPTEMBER 2011 (WEDNESDAY)

Time Tentative

12.00 pm ✓ Participant Registration

2.00 pm ★ Corporate Talk (Beckman Coulter 3S)Haemato-Flow - The trend?by Mr. Choong Chuan Yong of Beckman Coulter

2.45 pm ★ Corporate Talk (Cell-Dyn Abbot)Changing The Way We Look At The Cellsby Dr. Wan Hayati Binti Mohd. Yaakob of Hospital Tengku Ampuan Rahimah, Klang

3.30 pm ★ Free SessionMorphology Quiz & Booth Tour

4.15 pm High Tea

5.15 pm ➡ MMLHS Meeting


AGENDADAY 2: 29TH SEPTEMBER 2011 (THURSDAY)

Time Tentative

8.30 am ★ Opening Ceremony - by President of MMLHS

8.45 am • Classification of Acute leukemias by A/Prof Dr. Surender Juneja

9.30 am • Overview on the classification of MPD/MDSby A/Prof Dr. Rosline Hassan

10.30 am Photography Session & Tea Break

11.00 am • The Haemolytic Anemias by A/Prof Dr. Narazah Mohd Yusoff

12.00 pm • Application of automated haematology analyser in medical disorders by Prof. Dr. Kyung-Ja Han

1.00 pm ✦ Lunch Talk (Morphologic Clues form CBC Results) by Mr Woon Sung Thong (Sponsored by Sysmex)@ Dewan Green Pacific

2.30 pm ★ Case Studies - by A/Prof Surender Juneja

4.30 pm Tea Break

7.00 pm Morphology Quiz Submission Closing


AGENDADAY 3: 30TH SEPTEMBER 2011 (FRIDAY)

Time Tentative

8.30 am • The Lymphoproliferative Disorders by Emeritus Prof Dr. SK Cheong

9.30 am • Interpretation of BMA & Trephine Biopsies in Haematological Disorders (Part 1)by A/Prof Dr. Surender Juneja

10.30 am Tea Break

11.00 am • Interpretation of BMA & Trephine Biopsies in Haematological Disorders (Part 2) by A/Prof Dr. Surender Juneja

11.45 am ★ Morphology Quiz Session

12.30 pm Lunch Break & Friday Prayers

2.45 pm • Case Studies - by Emeritus Prof. Dr. SK Cheong

4.30 pm ★ Closing & Prize Giving Ceremony

5.00 pm Tea Break


SPEAKERSASSOCIATE PROFESSOR DR. SURENDER JUNEJA

Associate Prof. Dr Surender Juneja, MD, FRCPath.

After graduating from the University of Delhi in 1976, Surender, undertook an MD in Pathology at the All India Institute of Medical

Sciences. In 1981, accepted a Fellowship in Haematology at Hospital Henri Mondor, University of Paris XII, France. In 1983 Surender moved to Peter McCallum Cancer Centre as a fellow/registrar in Haematology

until 1987. In 1988 he accepted the position as Consultant Haematologist at Peter McCallum Cancer Centre, a post that he held

until 2000. During this time, he gained his Fellowship of the Royal College of Pathologists and took the position as Deputy Director of Pathology.

Surender is a member of the Haematology Society of Australia & New Zealand (HSANZ), the American Society of Haematology (ASH), the European Society of

haematology (EHA) and the International Society of Laboratory Haematology (ISLH). He has been the Principal Morphologist for the Australasian Leukaemia

Lymphoma Group (ALLG) since 1987. He is Co-chair & presenter at the QAP–Morphology session at the annual HSANZ meetings since 1997.

Today, Surender's expertise in Haematology Morphology, Immunohistology, Flow cytometry is revered and duely sought. He has 80 publications mostly in peer reviewed journals and has been invited to speak at a number of International &

National Scientific Meetings. He is also an examiner for FRCPA Haematology since 2001, a NATA Assessor and a Committee Member developing guidelines on

management lymphomas for the NHMRC.

Surender is the Head of Diagnostic Haematology and also holds appointments as Associate Professor in Pathology, University of Melbourne and as an Honorary Clinical Associate, Walter & Eliza Hall Institute of Medical Research – Cancer &

Haematology Division.


SPEAKERSEMERITUS PROFESSOR DR. SK CHEONG

Emeritus Professor Dr Cheong Soon Keng

Qualifications: MBBS(Malaya), MRCP(UK), DCP(London), FRCP(Glasgow), FRCP(Edinburgh), FRCPA(Australasia), FAM(Malaysia), FASc(Malaysia), FFSc RCPA (Australasia), FAM(Singapore)

Professor Cheong is currently the Professor of Medicine at the Faculty of Medicine & Health Sciences, Universiti Tunku Abdul Rahman, Malaysia. He is also the Visiting Consultant Haematologist to Hospital UKM.

He has been conferred Fellow of the Academy of Sciences Malaysia in 2001, Emeritus Professor of UKM in August 2007, Chair of Datuk & Datin Tan Kim Leong Professor of Medicine, UTAR in 2010, and Founding Fellow of the Faculty of Sciences, the Royal College of Pathologists of Australasia in 2011

Professor Cheong is actively involved in postgraduate training in pathology & internal medicine, and supervising currently a number of master and doctorate theses in medical sciences.

His current research interests include the biology of blood cancers, dendritic-cell-based vaccines, biology & application of mesenchymal stem cells, and web-based technologies for medical education.

He has also authored or co-authored more than 145 peer-reviewed articles and more than 250 abstracts of presentations.

His is currently the President of the College of Pathologists, Academy of Medicine of Malaysia.

Other positions currently held by him include: Emeritus Member of the American Society of Haematology, Country Representative to the World Association of Pathology & Laboratory Medicine, and Malaysia Councilor of the Royal College of Pathologists of Australasia.

He is an Associate Editor for “Haematology” and “Malaysian Journal of Pathology”. He is also the Vice President of the National Cancer Council (MAKNA), a non-profit charity organization.


SPEAKERSASSOCIATE PROFESSOR DR. ROSLINE HASSAN

Associate Professor Dr Rosline Hassan

Qualification : MD(UKM), MMed(Pathology)(Haematology), AM(Malaysia)

Currently Associate Prof Dr Rosline Hassan is the Head of Haematology Department and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia.

She is also a MS ISO15189 assessor for Department of Standard Malaysia, Ministry of Science Technology Innovation.

In addition she is also responsible for undergraduate and postgraduate teaching. She has supervised a handful of postgraduate students from both medical and biomedical

sciences course. She is also internal-external examiner of Haematology for Conjoint Board of Pathology, MALAYSIA.

Associate Prof Rosline has also authored and co-authored many journals and has presented many abstracts at conferences.

Her research interests are mainly molecular aspect of myeloid neoplasm and

haematological disorders such as thalassaemia, and transfusion medicine


SPEAKERSASSOCIATE PROFESSOR DR. NARAZAH MOHD YUSOFF

Associate Professor Dr Narazah Mohd Yusoff

Qualifications: PhD (Clinical Genetics), Kobe University Graduate School of Medicine, Kobe, Japan, Master in Medical Sciences (Haematology), University of London, Diploma in Clinical Pathology, University of London, Bachelor Medicine, Bachelor Surgery (MBBS), University of Malaya.

She is currently a consultant haematologist in Advanced Medical and Dental Institute (AMDI), USM, Bertam, Penang.

Among the posts held: Head, Department of Haematology, Director, Human Genome Centre, School of Medical Science, USM, Kubang Kerian, Deputy Director (Clinical Services), AMDI.

Her research interests include medical genetics, G6PD deficiency and red cell membrane disorders and has authored and co authored numerous peer reviewed articles. She is the Editor of Bio-health Science Bulletin.

Associate Professor Dr Narazah Mohd Yusoff is actively involved in post graduate training in haematology and transfusion medicine at Master’s and Doctorate level. She is currently the President of Members of Malaysian Society of Laboratory Haematology.

!


SPEAKERSPROFESSOR DR. KYUNG-JA HAN

Professor Dr Kyung-Ja Han

Dr. Kyung-Ja Han, M.D., Ph.D, is the Professor of the Department of Laboratory Medicine of The Catholic University of Korea.

Dr. Han graduated from The Catholic University Medical College. She has authored articles, abstracts, and book chapters on subjects including diagnostic haematology and

flow cytometry.

Dr. Han has served as a scientific board member of Association of Clinical Scientists for several years.

Currently, she is an active member of several professional societies, including the Korean Society of Laboratory Medicine and the Korean Society of Diagnostic Haematology where

she chairs and serves several committees, while holding elected positions.

Her clinical research interests focus in the areas of haematologic diseases, haematology laboratory, haematopathology and flow cytometry.


SPEAKERS MR. CHOONG CHUAN YONG

Mr Choong Chuan Yong

Mr Choong Chuan Yong has combines over 13 years of clinical laboratory experiance

including strategic marketing and new product commercialization.

He is currently the Marketing Manager for Beckman Coulter Malaysia and holds a

Bachelor of Science in Biomedical Sciences from UKM, Malaysia.

In his work with Beckman Coulter, he has responsibilities for all diagnostics products

including strategy, positioning and future additions.

He is passionate about haematology and flow cytometry and serving costumers’ needs in

all facets of his works.

1st Malaysian Society of Laboratory Hematology Scientific Meeting 2011 17


• Liquid Handling Systems and Consumable• Automated Pipetting System • Clinical, Multipurpose, Benchtop and Refrigerated Centrifuge• PCR Machine and Application

• HbA1C Analyzer • Thalassaemia Analyzer• EQAS ( External Quality Assurance System )• Quality Control for Diagnostics Analyzer.

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• Microbiology Products

• Hematology Analyzer (FBC) • Coagulation Analyzer

HQ : 1201, Taman Uda Murni, Jalan Pengakalan Chepa, 15400 Kota Bharu, Kelantan.Branch : No. 6, Lorong Shahzan IM 4, Taman Shahzan Indera Mahkota, 25200 Kuantan, Pahang Darul

Makmur.

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SPEAKERSDR. WAN HAYATI BINTI MOHD. YAAKOB

Dr Wan Hayati Binti Mohd. Yaakob

Dr. Hayati is a graduate form Universiti Sains Malaysia in 1998 she also holds a Master of Pathology in Haematology from Universiti Kebangsaan Malaysia in 2006.

Her vast working experiances begins in 1998-1999 as housemanship in Hospital Kuala Lumpur where she covers 4 months in Paediatric Department, 4 months in Surgery Department and 4 months in Obstetric and Gynaecology Department

In 1999- 2000 she begin practising as Medical Officer in Pusat Perkhidmatan Darah, Hospital Kuala Lumpur, then in 2000- 2002 as Medical Officer in Pusat Darah Negara. Afterwards in 2002- 2006 in Hospital Universiti Kebangsaan Malaysia and Hospital Kuala Lumpur she enrolled for post-graduate course (Masters in Pathology) in UKM.

After she holds her masters she practising at Hospital Tengku Ampuan Rahimah Klang, Selangor as a Haematologist in charge of haematology and transfusion medicine unit form June 2006 to date. She also sits in the Hospital Transfusion Committee member.


SPEAKERSMR. WOON SUNG THONG

Mr. Woon Sung Thong

Mr Woon is a graduate from University of Malaya and began his career as a Medical Laboratory Technologist in the University of Malaya Medical Centre in Kuala Lumpur from 1968 to 1999. During his tenure there, he was involved in the training and teaching of Medical Technologists, Medical Students, Biomedical Sciences students as well as doctors doing the Master in Pathology program.

He is also very active professionally. He is the President of the Malaysian Institute of Medical Laboratory Sciences, Secretary of the Laboratory Quality Assurance Scheme (LABQAS), which is a joint activity with the College of Pathologists Malaysia and a member of the National Medical Testing Accreditation Committee which oversees the implementation of ISO 15189 as well as a ISO 15189 technical assessor.

Regionally, he was instrumental and a founder member in the formation of the ASEAN Association of Clinical Laboratory Sciences and he Asia Association of Medical Laboratory Scientists. He is the current President of the ASEAN Association of Clinical Laboratory Sciences and a director of Asia Association of Medical Laboratory Scientists.

Today he is a freelance consultant to Sysmex Malaysia Sdn Bhd and Roche Diagnostics.


CORPORATE TALK 1HAEMATO-FLOW - THE TREND?

sponsored by:

(M) Sdn. Bhd.

by Mr Choong Chuan Yong

Most laboratories uses flow cytometers to further and absolute diagnosis of abnormal patient blood samples.

In year 2010, Beckman Coulter has launched a new flow cytometric reagents cocktail, CytoDiff to assist haematologists in their diagnosis.

CytoDiff is used during Haemato-Flow process to yield a 9 part Flow cytometry differential. Using CytoDiff combining with the haematology analyser will have a final 16 part differential.

Haemato Flow from Beckman Coulter not only saves laboratory time and money but also able to standardize the haematology laboratory workflow process which leads to more accurate and consistent results.

Haemato Flow CytoDiff is only available from Beckman Coulter and indeed the future of Cell Differential Analysis.


CORPORATE TALK 2CHANGING THE WAY WE LOOK AT THE CELLS

sponsored by: Laboratories (M) Sdn. Bhd.


LUNCH TALKMORPHOLOGIC CLUES FROM CBC RESULTS

sponsored by: (M) SDN BHD

by Mr Woon Sung Thong

Very often times, just by focusing closely at the CBC results together with the histograms and scattergrams, it is possible to have an advanced knowledge of what is to be expected in a peripheral blood film morphology. Take for example an increased RDW CV may signifies RBC anisocytosis but this is not always correct so by relying on RDW SD the correlation is more reliable. A dimorphic blood picture should be suspected if the RBC histogram shows multiple peaks. Much information can also be elucidated from P-LCR and MPV parameters about giant platelets or platelet clumps.

Evidence of fragmented RBC or schistocytes could be easily identified from the retic scattergram. Another piece of important information which can be derived from this same scattergram is fragmented WBC.

Sometimes it is important to pay attention to the background colour of the smear. If it is bluish it could mean that it is may be a case of multiple myeloma. The overproduction of immunoglobulin by the neoplastic plasma cells (myeloma cells) leads to marked rouleaux formation and an increase in the background staining (often bluish). If upon microscopic examination show otherwise then, heparin contamination of the blood sample should be considered.

A series of slides will be presented to illustrate these examples.


PLENARY TALK 1CLASSIFICATION OF ACUTE LEUKEMIAS

by Associate Prof. Dr. Surender Juneja

University of Melbourne, Australia

Within the past 50 years the first significant attempt at classification of acute leukaemias was made in 1976 when the French American British (FAB) Group of investigators proposed a classification, the so called FAB classification. This was a first major step in standardising the terminology & therefore reproducibility. The classification was based on morphology of Romanowsky stained smears and cytochemistry. Subsequently the FAB Group added further subtypes. However the discovery of a number of genetic lesions that predict clinical behaviour & outcome better than morphology alone meant that those data needed to be incorporated into the classification to be clinically meaningful.

Based on deliberations of the European Association for Haematopathology & the Society for Haematopathology, in 2001WHO classification was proposed & updated in 2008. The classification aims to define & subclassify leukaemias, standardise the nomenclature as well as gives an idea of the clinical relevance. This classification uses morphology, cytochemistry, immunophenotype, cytogenetic/molecular features & clinical features to define acute leukaemias.

Current outline of classification includes:• Acute myeloid leukaemia (AML) not otherwise categorised includes the 7 FAB

categories from minimally differentiated AML (M0) to acute megakaryoblastic leukaemia (M7); in addition, there are other AMLs like acute basophilic leukaemia, acute panmyelosis with myelofibrosis & myeloid sarcoma.

• AMLs with recurrent genetic abnormalities like t(8;21) (q22;q22), AML with inv (16)(p13.1q22) or APL with (t15;17) are considered as AMLs regardless of the blast count; for all others blasts >20% of peripheral blood or all nucleated BM cells is required.


• In APLs with t(15;17) (q22;q12), variant RARA translocations with other partner genes may not have typical APL features

• New cytogenetically defined entities t(6;9)(p23;q23); AML with inv (3) and AML (megakaryoblastic) with t(1;22)

• AML with MDS related changes has replaced AML with multilineage dysplasia & applies to patients with h/of MDS, dysplasia in >50% of cells of at least 2 lineages or myelodysplasia related cytogenetic abnormality

• Provisional entities AMLs with NPM1 & AML with mutated CEBPA have been added. It is recommended to test for FLT3 mutation in all cytogenetically normal AML

Acute lymphoblastic leukaemias (ALL) are classified as • Precursor B-lymphoblastic leukaemia/lymphoma with various cytogenetic

subcategories &• T lymphoblastic leukaemia/lymphoma

Acute leukaemias of ambiguous lineage include acute undifferentiated, mixed phenotype or others.The current classification provides an “evidence based” classification that can be used in daily practice for therapeutic decisions & yet provide a flexible framework for integration of new data.An essential feature of any classification is that it needs to be updated periodically to incorporate new information that has become available. There is no doubt that the current WHO classification will be updated as more new information accumulates.


PLENARY TALK 2OVERVIEW ON THE CLASSIFICATION OF MPD/MDS

by Associate Prof Dr. Rosline Hassan

Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia

Myeloproliferative neoplasm is a group of myeloid disorders known previously as

myeloproliferative disease (MPD) when it was first identified in 1951 by William

Dameshek. Later World Health Organization (WHO) 2001 showed a paradigm shift from previous schemes which were based on morphology, cytochemical, immunophenotypic,

and clinical information to incorporate genetic information. 2001 World Health Organization (WHO) classify chronic myeloproliferative diseases (CMPDs) as four classic

myeloproliferative disorders (MPDs)—chronic myelogenous leukemia, polycythemia vera

(PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF)—as well as chronic neutrophilic leukemia (CNL), chronic eosinophilic leukemia/hypereosinophilic

syndrome (CEL/HES) and ‘CMPD, unclassifiable’. In the recent WHO 2008 classification, the term ‘CMPDs’ is replaced by ‘myeloproliferative neoplasms (MPNs)’, and the MPN

category now includes mast cell disease (MCD), in addition to the subcategories

mentioned above. These myeloid neoplasms and several new entities were based on molecular pathogenesis, identification of new diagnostic and prognostic markers, and

progress in clinical management. Protein tyrosine kinase abnormalities, including translocations or mutations involving ABL1, JAK2, MPL, KIT, PDGFRA, PDGFRB, and

FGFR1 have been used as the basis for classifying myeloproliferative neoplasms (MPN).

Two new entities - refractory cytopenia with unilineage dysplasia and refractory cytopenia of childhood have been added to the group of myelodysplastic syndromes (MDS).


PLENARY TALK 3THE HAEMOLYTIC ANEMIA

by Associate Prof Dr. Narazah Mohd Yusoff

Advanced Medical & Dental Institute (AMDI), Universiti Sains Malaysia (USM)

Haemolytic anaemia is defined as anaemia due to haemolysis where there is accelerated

and abnormal breakdown of red blood cells (RBCs). This may happen either in the blood

vessels (intravascular haemolysis) or elsewhere in the human body (extravascular). The general classification of haemolytic anaemia is either inherited or acquired. In the

management of patients with suspected haemolysis, the first step is to confirm haemolysis and once confirmed the subsequent step is to find the cause of the

haemolysis. Numerous causes are associated with haemolysis and they may share some

common features, however some disorders may have characteristics which are unique to those disorders. These are tests for red blood cell destruction and specific tests can

identify the types of haemolytic anaemia. They are usually performed when haemolysis is suspected or has been determined. Treatment depends on the cause and nature of the

breakdown.

http://en.wikipedia.org/wiki/Anemia

http://en.wikipedia.org/wiki/Anemia

http://en.wikipedia.org/wiki/Hemolysis

http://en.wikipedia.org/wiki/Hemolysis

http://en.wikipedia.org/wiki/Red_blood_cell

http://en.wikipedia.org/wiki/Red_blood_cell

http://en.wikipedia.org/wiki/Blood_vessel




http://en.wikipedia.org/wiki/Heredity

http://en.wikipedia.org/wiki/Heredity


PLENARY TALK 4APPLICATION OF AUTOMATED HAEMATOLOGY

ANALYSER IN MEDICAL DISORDERSby Prof Han Kyung-Ja

Department of Laboratory Medicine, Hospital Catholic Korea

Complete blood cell count (CBC) of automated haematology analyzer is one of main laboratory tests for diagnosis and monitoring of medical and haematology disorders. There are many automated haematology analyzer instruments with different methodology. Recently, Beckman Coulter (BEC) launched a new automated haematology analyzer UniCel DxH800 with innovative principle.

At first, I would like to introduce Screening of Malaria and Parasite counting using DxH800. Each year, there are more than 225 million cases of malaria, killing around 781,000 people each year according to the latest WHO report. The endemic area is Africa, Asia including southern China and India. Microscopy of blood smear; The gold standard of malaria diagnosis is microscopic examination of the blood. Although it is a rapid, cost effective and easily applicable method, its sensitivity, specificity and precision are low and needs experts’ technique and experience, labor intensive and time-consuming. The automated haematology analyzer has been insufficient for detection and counting of Plasmodium in the blood until now. DxH800 shows characteristic malaria signature position on nRBC plots and 5PD plots. And the size of the population is roughly correlated with the parasite count.

Next topic is ‘Screening of Sepsis and Other Diseases using Leukocytes Cell Population Data (CPD)’. DxH800 reports cell population data(CPD) of many blood cell population as an additional data. They reflect many kinds of cellular characteristics. Using combination


of CBC and leukocytes CPD, decision rules for a specific disease could be developed. Decision rule for sepsis will be presented here. Sepsis(bacteremia & fungemia) is a rapidly progressing, life threatening condition that can cause shock and organ failure, if not treated immediately. Sepsis samples showed much difference in many leukocyte CPD comparing to normal sample. Using combination of CBC and CPD, the decision rule for screening of sepsis and other diseases could be developed and easily applied in Lab environment.

The last topic is about ‘Reliable, Accurate Leukocyte Differential counting of Leukopenic Samples using Haematoflow’. The manual differential of leukopenic samples has very poor precision because insufficient number of cells are counted. And it is very time-consuming and sometimes very difficult to classify cells. Number of leukopenic samples has been increased rapidly due to increased patients with chemotherapy, radiotherapy and transplantation. Recently, BEC launched CytoDiff reagent with autogating Flow cytometric differential software. Using combination of CBC of DxH800 and Cytodiff results of Flow Cytometry(this combination of Haematology and Flow cytometry is called as Haematoflow), 16-parameters -WBC differential count is achievable. This method showed higher precision and accurate results than manual differential count especially in leukopenic samples.


PLENARY TALK 5THE LYMPHOPROLIFERATIVE DISORDERS

by Emeritus Prof Dr. SK Cheong

Faculty of Medicine & Health Sciences, Universiti Tunku Abdul Rahman

The lymphoproliferative disorders are lymphoid neoplasms resulting from clonal

proliferation of mature or immature lymphoid cells. Most lymphoid neoplasms have a

corresponding normal maturation stage. They may arise from the central lymphoid tissues

or peripheral lymphoid tissues. Many classification schemes have been formulated over

the years and the most recent is the WHO Classification 2008. This Classification utilises

available information to define disease entities to guide treatment and prognostication. For

practical purpose, morphology and immunophenotyping by flow cytometry or

immunohistochemistry are sufficient to distinguish most lymphoid neoplasms. Some

lymphoid neoplasms have characteristic genetic abnormalities. Precursor lymphoid

neoplasms are diseases of childhood. T-cell neoplasms often present as lymphoma with

mediastinal disease. 90% of the lymphoid neoplasms are mature B cells, of which DLBCL

and Follicular lymphoma constitute about 60% of the B-cell malignancies. Most patients

with lymphoid neoplasms lack evidence of immune system abnormalities, but patients with

immunodeficiencies and autoimmune diseases are at risk to lymphoid neoplasms. The

etiology for most lymphoid neoplasms remain unknown. However, EBV, human

herpesvirus 8, human TLV I, hepatitis C, H. pyroli, chlamydia and campylobacter have

been implicated in some distinct lymphoid neoplasms.


PLENARY TALK 6INTERPRETATION OF BONE MARROW ASPIRATES &

TREPHINE BIOPSIES IN HAEMATOLOGICAL DISORDERS

by A/P Dr. Surender Juneja

University of Melbourne, Australia

Bone marrow examination is a routine investigation performed to assess many haematological & non-haematological disorders. It comprises bone marrow aspirate most often accompanied by a trephine biopsy. Since the aspirate & biopsy provide complementary information, it is exceptional to perform either aspirate or trephine biospy alone. The aspirate smears are stained with one of the Romanowsky stains like the ICSH stain & the trephine biopsies with the haematoxylin & eosin with or without special immunohiostochemical stains.

The interpretation of the aspirate is based on examination of a Romanowky stained aspirate smear. This must always be interpreted with the appropriate clinical context, the results of peripheral blood findings ie blood counts & the morphologic examination of the blood smear. It is important that specimens for all ancillary investigations eg flow cytometry, cytogenetics & molecular studies are taken at the time of the procedure & therefore communication between the person doing the biopsy & the one requesting is critical

Correlation with trephine biopsy & ancilliary investigations like flow cytometry, cytogenetics & molecular studies may also be required in many cases. For example, the burden of plasma cell infiltrate in myeloma at diagnosis or after treatment is best assessed on CD138 stained trephine biopsy combined with aspirate differential. The


subtyping of lymphoma with marrow involvement often requires correlation with flow cytometry findings and/or immunohistology. Accurate diagnosis & subtyping of leukaemias ofen requires correlation with cytochemistry, flow cytometry & cytogentic/molecular studies.

At our institution the bone marrow aspirate is examined on the day it is performed and the trephine biopsy the next day. A final report combining the aspirate & trephine biopsy is issued. The urgency of reporting depends upon the clinical situation. The aspirate results when diagnostic may be communicated within minutes to hours whereas cases requiring correlation with immunohistochemistry, flow cytometry, cytogenetics or molecular studies may require days. A provisional report may be issued as soon as practical however, it is desirable to issue a final report incorporating all results from all elements of diagnostic studies eg morphology, cytochemistry, immunohistology, flow, cytogenetics & molecular studies.

Finally a discussion of the results particularly the difficult cases with the clinician either by phone or at a multidisciplinary meeting will allow clarification & communication of results.


ENTRANT REGISTERSNo. Name Institution email

1 ABDUL KHADIR MAT (DR) JABATAN PATOLOGI, HOSP.TAIPING Fax: 05-8079300

2 ABDULLAH HAFIZ KAMARUDDIN HAEMATOLOGY,PPSP,USM [email protected]

3 AEDELLY RAYNER UNIVERSITI MALAYSIA SABAH [email protected]

4 AIDA IBRAHIM PANTAI PREMIER PATH SDN BHD [email protected]

5 ANGELI AMBAYYA HOSP AMPANG [email protected]

6 ANIS AMIRA JAAFAR (DR) UNIT HEMATOLOGI, HRPZ 11 [email protected]

7 AZHAR ABDUL RAHIM UNIT HEMATOLOGI,HKL [email protected]

9 AZILAWATI AZIZAN HAEMATOLOGY,PPSP, USM [email protected]

8 AZIZON OTHMAN (DR) PATOLOGI,HOSP. SEREMBAN [email protected]

10 AZLINDA ABU BAKAR (DR) Patologi, Hosp Queen Elizabeth [email protected]

11 AZLY SUMANTY AB GHANI (DR) H.SULTANAH NUR ZAHIRAH, TRG [email protected]

12 BALAN MENON KLINIK KESIHATAN SEBERANG JAYA [email protected]

13 BASKARAN SUBRAMANIAN (DR) UNIVERSITI PUTRA MALAYSIA [email protected]

14 CHOO HUA LEE DRIVE COUNT MEDICAL CENTRE -

15 FAIZATUL SYIMA ABDUL MANAF IPPT,PULAU PINANG. [email protected]

16 FARIDAH IDRIS (DR) UNIVERSITI PUTRA MALAYSIA [email protected]

17 FATIMAH MD ISA (DR) PATOLOGI,HOSPITAL SERDANG [email protected]

18 FAUZANA KAMARUZZAMAN (DR) PPUKM [email protected]

19 ELIZABETH GEORGE (PROF DR) HEMATOLOGI,UPM [email protected]@hotmail.com

20 GOH BEE HEONG PANTAI PREMIER PATH SDN BHD [email protected]

21 HANAN MAHMOOD (DR) HOSPITAL KUALA LUMPUR [email protected]

22 IDA MARHAINIS ISAHAK (DR) JAB.PATH, HOSP. KUALA LUMPUR [email protected]

23 ILUNIHAYATI IBRAHIM (DR) UNIT HEMATOLOGI, HRPZ 11 -

24 JACYKA JAIBI UNIVERSITI MALAYSIA SABAH [email protected]

25 JAZWINA JAUHAR (DR) PATOLOGI,HOSHAS,TEMERLOH [email protected]

26 JESSIE LOI ALL EIGHTS SDN.BHD [email protected] KHAMISAH MOHD GAUS (DR) HOSP RAJA PERMAISURI BAINUN [email protected]

28 LEE YIN JONG PANTAI PREMIER PATH SDN BHD [email protected]

29 LEE CHOY HAR HOSP.RAJA PERMAISURI BAINUN ,IPOH

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30 LIM HUEY NEE UNIVERSITI MALAYSIA PERLIS limhueynee @gmail.com

31 LIM JOO SIANG PANTAI PREMIER PATH SDN BHD [email protected]

32 MADYAH ABDUL MONIR (DR) UITM KAMPUS SG.BULOH. [email protected]

33 MAIMUNAH ISMAIL HOSPITAL GRIK 019-9457612 (ABD RAHMAN)

34 MARINI RAMLI (DR) HEMATOLOGI,PPSP,USM [email protected]

35 MAZRUL EFFENDYDUKOT SOEHARTO PATHOLOGY,HOSP. SG BULOH FAX; 03-61562645



36 MOHD NAZRI HASSAN (DR) HSP SLTNH NUR ZAHIRAH [email protected]

37 MOHD SALIM ZULKIFLI HOSP.TUANKU JAAFAR,SEREMBAN [email protected]

38 MOHD SYAHRUL JOGRI MAT ZAIB PATOLOGI DEPT. H.SUNGAI BULOH Fax: 03-6156245

39 MOHD TOHIT EUSNI RAHAYU (DR) FAC. MED, UPM [email protected]

40 MOHD YAZID RAMLI JAB.PATOLOGI,HOSP. S.JAYA sally–[email protected]

41 MOHAMAD BASIR SELVAM ABDULLAH IPPT,PULAU PINANG. -

42 MUHAMMAD AZNEE AZMAN PANTAI PREMIER PATH SDN BHD [email protected]

43 MUHAMAD HAMIDI HAMID PUSAT KESIHATAN DAERAH GRIK 019-9457612(ABD RAHMAN)

44 MUHAMMAD JAVED ASIF (DR) SHAIK ZAYED MEDICAL COMPLEX, LAHORE,PAKISTAN

[email protected]

45 MUHAMAD SYAFIQ SHARIAN HOSP.KUALA KANGSAR [email protected]

46 MUNIRAH ABD RAZAK (DR) PATOLOGI,HOSP. SEREMBAN -

47 MUSTAFA LANGA (DR) HAEMATOLOGY,HUKM [email protected]

48 NADIATUN ZAWIYAH SUPARDI UNIVERSITI MALAYSIA PERLIS [email protected]

49 NARAZAH MOHD YUSOFF(PROF MADYA) IPPT,USM, KEPALA BATAS [email protected]

50 NATASYA ANNE ASOKENDARAN (DR) PPUM/HKL [email protected]

51 NAZRI ABDUL MUTHALIB (DR) HOS. SULTANAH BAHIYAH [email protected]

52 NIK HAFIDZAH NIK MUSTAPHA (DR) HOSP.TUANKU JAAFAR,SEREMBAN [email protected]

53 NIK MUHD KHUZAIMI NIK MAN HEMATOLOGI,PPSP.USM -

54 NIZMAH MAHANI MOKHRI (DR) PATHOLOGY ,H.QUEEN ELIZABETH [email protected]

55 NOOR HASLINA MOHD NOOR (DR) HAEMATOLOGY,PPSP,USM [email protected]

56 NOORME ZAIHANE NORDIN PANTAI PREMIER PATH SDN BHD [email protected]

57 NOORULHUDA MOHD MOKHTAR (DR) HEMATOLOGI,USM [email protected]

58 NOR KHAIRUL PUTRA MOHD MADI HAEMATOLOGY,HUSM [email protected]

59 NORMALA ABD MALIK PANTAI PREMIER PATH SDN BHD [email protected]

60 NOR SUHAILA MD RIFFIN (DR) PATOLOGI,H. SULTAN HJ AHMAD SHAH,TEMERLOH, PAHANG

[email protected]

61 NORAHNINZU ARIFIN (DR) HEMATOLOGI,USM [email protected]

62 NORASYIKIN MOHAMAD AZMIE (DR) PATOLOGI,H.TENGKU AMPUAN AFZAN [email protected]

63 NORAZLINA AZMAN (DR) PPUKM [email protected]

64 NORITA OSMAN NATIONAL BLOOD BANK [email protected]

65 NORSIMA NAZIRAH SIDEK UNIVERSITI MALAYSIA PERLIS [email protected]

66 NOR ZILAH MOHAMAD INSTITUT PERUBATAN RESPIRATORI Fax: 03-40218807

67 NUR ASMA MOHD NAWI HOSP AMPANG [email protected]

68 NURHANANI AHMAD (DR) PATHOLOGY,HOSP. SG BULOH FAX; 03-61562645

69 NUR HAZYYAH HASSAN HEMATOLOGI,USM [email protected]

70 NUR ILANI NOH PATOLOGI,HOSHAS,TEMERLOH [email protected]



71 NURUL AIN FATHMA ABDULLAH HEMATOLOGI,PPSP.USM [email protected]

72 NURUL FATHIHAH MOHD JALIL PATOLOGI ,HOSP.SLIM RIVER [email protected]

73 NURULHUDA ABD KADIR (DR) PATOLOGI,HOSP.SEBERANG JAYA Fax: 04-3970751

74 NURUL HAZWANI ABD. HALIM UNIVERSITI MALAYSIA PERLIS [email protected]

75 NURUL SYUHADA MUHAMED ZAINI HOSP.BALIK PULAU,PENANG [email protected]

76 NURUL ZHAFIKHA NOOR RASHID UNIVERSITI MALAYSIA PERLIS [email protected]

77 PIM CHAU DAM (PROF MADYA) PPSK, USM [email protected]

78 PRATHIBA BALAIKERISHNAN PATOLOGI ,HOSP.SLIM RIVER [email protected]

79 RAFIZA ROSLIN PATHOLOGY,HOSP. SG BULOH FAX; 03-61562645

80 RAHIMAH AWANG HOSP AMPANG [email protected]

81 RAPIAAH MUSTAFFA (PROF MADYA DR) HEMATOLOGI,USM [email protected]

82 RASHIDAH MOHAMED (DR) HOSP AMPANG [email protected]

83 ROHANI BAKAR IPPT,PULAU PINANG [email protected]

84 ROMINA GREY MELVIN UNIVERSITI SARAWAK [email protected]

85 ROSLAN ABD AZIZ HOSP KAJANG [email protected]

86 ROSNAH BAHAR (DR) PPSP, USM [email protected]

87 ROZIAH ABDUL TALIB JABATAN PATOLOGI, HOSP.TAIPING FAX: 05-8079300

88 RUSMAWATI ISMAIL (DR) H.TENGKU AMPUAN AFZAN,KUANTAN [email protected]

89 SABARIAH MD NOOR (DR) UNIVERSITI PUTRA MALAYSIA [email protected]

90 SALIM AHMAD PATHOLOGY,HOSP. SG BULOH FAX; 03-61562645

91 SALMAH ARSHAD (DR) JAB.FORENSIK,HOSPITAL SERDANG [email protected]

92 SHAFINI MOHAMED YUSOFF (DR) HAEMATOLOGY ,USM [email protected]

93 SHAHIZAN MAT JENAN NATIONAL BLOOD BANK [email protected]

94 SHAIFFUL FIRDAUS JAMALUDDIN HAEMATOLOGY,HUSM [email protected]

95 SHARIFAH MAI SARAH SYED AZIM (DR) PPUKM [email protected] SITI A’INI SYAZRAH MOHAMAD (DR) JAB.PATOLOGI ,HKL [email protected]

97 SITI FAIRUZ HASHIM (DR) PATOLOGI,H.TENGKU AMPUAN AFZAN [email protected]

98 SITI NURUL HAWA ABD RASHID PUSAT KESIHATAN DAERAH GRIK 019-9457612 (ABD RAHMAN)

99 SITI ZUBAIDAH MUSTAPHA (DR) HEMATOLOGI,HTAR,KLANG [email protected]

100 SRLY SAMAN IPPT, PULAU PINANG

101 SUHAIR ABBAS AHMED (DR) PPSP, USM [email protected]

102 SUHANA HASHIM JAB. PATOLOGI ,HRPZ II [email protected]

103 SURYATI ABDULLAH HAEMATOLOGY,PPSP,USM [email protected]

104 SURYATI HUSSIN (DR) PATOLOGI, HOSP.KUALA KRAI [email protected]

105 SUZIANA MOHD NASIR (DR) JAB.PATH, HOSP. KUALA LUMPUR [email protected]



106 TANG YEE LOONG (DR) UNIERSITI KEBANGSAAN M’SIA [email protected]

107 THATCHEIANY KUMARIAH (DR) UNIVERSITI MALAYA [email protected]

108 TOH SEE GUAN (DR) DEPT.OF HAEMATOLOGY HOSP.P.PINANG

[email protected]

109 TUAN HULWANI T. MOHAMMAD (DR) HOSP.PULAU PINANG [email protected]

110 TUAN NOR BALIZA HOSP.RAJA PERMAISURI BAINUN ,IPOH

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111 UMA PONNUDURAI (DR) JAB.PATH. HOSP.KUALA LUMPUR [email protected]

112 WAI ZHUO HAN MERCK SDN. BHD. [email protected]

113 WAN AMAL HAYATI WAN HASSAN (DR) PATOLOGI,H.TENGKU AMPUAN AFZAN [email protected]

114 WAN ASMUNI MOHD SAMAN (DR) HEMATOLOGI,USM [email protected]

115 WAN HAYATI MOHD YAAKOB (DR) HTAR, KLANG [email protected]

116 WAN LIZA WAN NORDIN PATOLOGI,HOSP.KUALA KRAI [email protected]

117 WAN SURAYA WAN ALI INSTITUT PERUBATAN RESPIRATORI Fax; 03-40218807

118 WAN SURIANA WAN AB RAHMAN (DR) PP.SAINS PERGIGIAN , USM [email protected]

119 WOO YEE SUET PANTAI PREMIER PATH SDN BHD [email protected]

120 YOGESWARY A/P SWARAJA PATHOLOGY,HOSP. SG BULOH FAX; 03-61562645

121 YUSLINA MAT YUSOFF (DR) PPUKM [email protected]

122 ZAMRI AHMAD HOSP. MELAKA [email protected]

123 ZEFARINA ZULKIFLI (DR) PPSK, USM [email protected]

124 ZUBAIDAH ZAKARIA (DR) IMR, JLN PAHANG ,KUALA LUMPUR -


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