The Hematologist

July-August 2011, Volume 8, Issue 4

ASH Helps to Build Capacity for Cytogenetics Laboratories in Mexico

LoAnn Peterson, MD

Published on: July 01, 2011

Director of Hematopathology, Professor of Pathology, Feinberg Medical School, Northwestern University, Northwestern Memorial Hospital

In April, medical professionals from the United States and Mexico met in Mexico City to kick off a pilot program designed to standardize cytogenetics laboratory procedures for the diagnosis of hematologic malignancies in Mexico. This meeting came about after AMEH (La Agrupación Mexicana para el Estudio la Hematología [the Mexican hematology association]) asked ASH to help investigate ways to build capacity for hematologic cytogenetics laboratories in Mexico. The U.S.-Mexico Cytogenetics Laboratory Standardization Program was then established as a science-based educational collaborative partnership that includes ASH, AMEH, and the U.S. NCI Office of Latin American Cancer Program Development (OLACPD). The ultimate goal of this program is to improve the diagnosis and care of patients with hematologic malignancies utilizing high-quality cytogenetic analysis.

One of the first steps was to establish a Scientific Steering Committee consisting of a group of experts representing AMEH, ASH, and the NCI OLACPD to oversee the program. The committee includes AMEH Past President David Gómez Almaguer, MD, PhD; Hector Mayani, PhD; Diane Arthur, MD; Michelle Le Beau, PhD; Susana Raimondi, PhD; Jorge Gomez, MD, PhD; and me. Subsequently, four experienced cytogenetics laboratories representing different geographic areas of Mexico were selected to work in partnership with the Scientific Steering Subcommittee. The participating laboratories include Laboratorio de Analisis de Oncohematologia in Mexico City, Neuvo Hospital Civil in Guadalajara, Laboratorios Mendel in Morelia, and Genetica Estudios Pre y Postnatal in Mexico City.

On April 7-8, 2011, an initial workshop to plan a two-year pilot project for the cytogenetics standardization program was held in Mexico. The focus of the pilot project, which will be sponsored in part by the Wallace H. Coulter Foundation, is cytogenetic analysis of de novo acute myeloid leukemia (AML). Representatives of the Scientific Steering Committee visited the four participating cytogenetics laboratories, and members of the Committee gave state-of-the-science presentations on genetics of AML, including the biologic and clinical implications of genetic abnormalities. These were followed by collaborative discussions between committee members and laboratory representatives about the process for implementing the pilot to ensure that the project was a Mexican-led initiative. Enthusiasm for the pilot project among the workshop attendees was unanimous.

Participating laboratories are now prospectively performing cytogenetic analysis at diagnosis on adult and pediatric patients with AML. Representative karyotypes and their interpretation will be entered into the Pediatric Oncology Network Database (POND) based at St. Jude Children’s Research Hospital. The cytogenetic data will be centrally reviewed by experts on the Scientific Subcommittee, and feedback will be provided to the participating laboratories. Diagnostic pathology material, such as bone marrow aspirates and relevant clinical and laboratory data, will also be reviewed and correlated with the cytogenetic results. Performance will be measured and compared with established short-term and long-term goals. The Steering Committee and participating laboratories have contributed an enormous amount of time and energy to ensure a successful launch. Over the course of the two-year project, the aim will be to improve cytogenetic analysis in Mexico by creating centers of excellence that can then train other laboratories in the country. Ultimately, the goal of this collaboration between ASH, AMEH, and NCI is to improve outcomes for patients with AML.

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