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Moving forward and enlightening the future together! From January 6 to 8, 2023, the 3rd China Hematology Development Conference was grandly opened
.
With the theme of "Big Blood, Big Health, Big Health - Drawing a New Blueprint for the Development of Hematology", the conference joined hands with more than 100 experts and scholars at home and abroad to discuss the cutting-edge achievements in the field of hematology and seek the construction and vigorous development
of hematology.
On this occasion, Yimaitong specially invited Professor Xiao Zhijian from the Hospital of Hematology, Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences) to be interviewed to share the current situation and thinking
of accurate diagnosis of blood system diseases in China.
Professor Xiao Zhijian
Chief physician, professor, doctoral supervisor
Deputy Director of the Hematology Hospital of the Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences).
Director of MDS Diagnosis and Treatment Center, Hematology Hospital, Chinese Academy of Medical Sciences, Director of Hematology Diagnosis Center
Vice Chairman of Hematology Branch of Chinese Medical Association
Leader of Leukemia Lymphoma Group, Hematology Branch of Chinese Medical Association
His research interests include the molecular mechanism and new clinical diagnosis and treatment strategies of myeloid tumors, especially myelodysplastic syndromes and myeloproliferative tumors
He has won the titles of "New Century Millions of Talents Project" national candidate, "young and middle-aged experts with outstanding contributions" of the Ministry of Health, "special government experts" and "national outstanding scientific and technological workers" of the State Council
Associate editor of Chinese Journal of Hematology, International Journal of Blood Transfusion and Hematology and Leukemia and Lymphoma, and editorial board member of Blood Review, Gene, Chromosomes and Cancer
The 3rd China Hematology Development Conference specially set up a special forum on "Accurate Diagnosis of Blood Diseases", please briefly introduce the current development status of hematopathological diagnosis of blood system diseases in China? What other problems are you facing?
Professor Xiao Zhijian
Precision medicine mainly includes precision diagnosis and precision treatment, without accurate diagnosis, there is no precision treatment, but at present, China's accurate diagnosis of blood pathology still faces some problems: First, some new diagnostic technologies, such as second-generation flow cytometry (NGF), second-generation sequencing (NGS), digital PCR and single-cell and spatial omics, are inseparable from laboratory self-built detection (LDT).
On February 9, 2021, the State Council issued the latest version of the Regulations on the Supervision and Administration of Medical Devices, which recognized the LDT model
.
However, how to manage LDT is a problem
that China must face and solve.
Second, specialized training of hematologists is also crucial
.
This forum specially invited Professor Wang Liang of the United States to introduce to us how to train hematology specialists in the United States, which is worth learning for the future training of hematologists in China
.
In addition, it is important
to integrate pathology reports.
At present, clinicians in China are facing difficulties in interpreting some experiments, which poses a new challenge for pathologists, that is, to integrate morphology, flow cytometry, molecular biology, cytogenetics, etc.
to form a comprehensive diagnostic report
.
Compared with previous reports, the integrated pathology report should also include the interpretation of the results, and only by reading the report can clinicians better guide precision treatment
based on the report.
The advancement of clinical detection technology has promoted the development of clinical diagnosis and treatment, NGS has made the molecular biology characteristics of myelodysplastic syndrome (MDS) clearer, and the update of the 5th edition of the WHO hematolymphatic system tumor classification in 2022 has attracted widespread attention, what do you think is the significance of the new classification diagnostic criteria?
Professor Xiao Zhijian
In 2022, there are two typing systems in the field of hematologic diseases that deserve everyone's attention: the first is the update of the fifth edition of the WHO hematopoietic lymphoma typing diagnosis, and the second is the international proposal of a new classification and diagnosis system for myeloid tumors - the International Consensus Classification (ICC).
Although there are two different diagnostic criteria for typing, the principles of typing are the same, i.
e.
, cytogenetics and molecular biology take precedence over traditional morphology-based classification principles
.
The formulation of such principles is mainly based on clinical needs
.
In the past few years, the treatment of blood system diseases is mainly to explore the gene mutation lineage or the molecular pathological mechanism of disease pathogenesis, for new abnormal genes and affected signaling pathways, new targeted drugs emerge one after another, with the successive clinical trials, these new drugs are on the market quickly, so how to guide the use of these drugs is the key; And with the development of immunotherapy, from monoclonal antibodies, dual antibodies, to tertiary antibodies and CAR-T cell therapy, how to choose the right patient is also a problem
that must be faced.
Therefore, based on these clinical needs, the precision of classification diagnosis is particularly important, based on pathogenesis, pathogenesis, cellular and molecular genetics, the classification and diagnosis of patients can better guide patients to choose new drugs in the next reasonable step, and maximize the value of new drugs
.
At the same time, especially in our country, we should take into account the problem of
pharmacoeconomics.
How to combine new drugs with traditional economic solutions needs to be further explored
.
From this point of view, the new typing diagnosis can provide a framework and premise
for solving problems for future clinical accurate and standardized treatment.
MedPulse: The MDS diagnosis and treatment strategy based on NGS is a reflection of the development of precision medicine, but there is still a long way to go to achieve true precision diagnosis and treatment of blood diseases, what is your outlook for the future development of precision diagnosis and treatment of blood diseases?
Professor Xiao Zhijian
First of all, in addition to relying on technology, accurate diagnosis also involves a new examination method, that is, LDT
.
The key to LDT lies in quality control, including the verification of testing performance, clinical performance and the establishment of a complete set of quality control management system, accurate results are the most basic requirements, but at present, many examinations of China's blood system are completed in the hematology department's own laboratory, and there is still a long way to go in the verification and establishment of the quality control system
.
Second, the problem of pharmacoeconomics remains to be solved
.
It costs more to do a complete set of tests for patients with hematological tumors, and although the national medical insurance policy has made new adjustments, it is still a bottleneck problem
to be broken through for the problem of pharmacoeconomics.
In general, with the development of the past 20 years, the occurrence, development, evolution, prognosis, outcome, and choice of treatment regimen of different blood system diseases have relied more on molecular science, and I believe that omic classification is an irreversible overall development trend
of future classification diagnosis.
Although the development of accurate diagnosis in China is still in its infancy, there are still many problems to be solved, but as long as China's hematology colleagues work together, we will be able to achieve the overall goal
of running from following to running, and leading in some aspects in the future.
: Moly Reviewed: Quinta Typesetting: Moly Executive: Moly
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Poke "Read Original" to watch the wonderful replay of the meeting
