2019 Issues

A heads-up on hybrid lab models of genetic testing
August 2019—Little attention has been paid to the emergence and effect of hybrid laboratories—those that fall in the middle ground between the direct-to-consumer and traditional models, say the authors of an opinion piece published in the June 25 issue of JAMA. Kathryn Phillips, PhD, Julia Trosman, PhD, and Michael Douglas, MS, of the Center for Translational and Policy Research on Personalized Medicine, University of California, San Francisco, say the emergence of the hybrid model, in which a clinician orders the test and returns results, “has significant implications for everyone involved in genetic testing,” providing potential benefits and risks.Greater access and convenience and lower cost for the consumer are among the potential benefits they list. Among the concerns: reduced continuity of care, profit motivation, and insufficiently extensive guidance and counseling. But there are other challenges with hybrid laboratories, they say.

Editor: Deborah Sesok-Pizzini, MD, MBA, professor, Department of Clinical Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and chief, Division of Transfusion Medicine, Children’s Hospital of Philadelphia. Financial impact of approaches to reduce bacterial contamination of platelet transfusions August 2019—The leading infection risk from blood transfusion is bacterial contamination, which is most likely due to the entry of small quantities of skin flora at the time of blood donation or collection from asymptomatic donors with unknown

Evaluation of pan-TRK IHC in infantile fibrosarcoma, lipofibromatosis-like neural tumor, and histological mimics.
August 2019—Infantile fibrosarcoma is characterized by intersecting fascicles of spindle cells and ETV6-NTRK3 gene fusion in most cases. Given histological overlap with other spindle-cell tumors, the diagnosis can be challenging and often requires molecular confirmation. A recently developed pan-TRK antibody shows promise for identifying tumors with NTRK fusions.