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Advances in the Laboratory Assessment of Hemostatic and Thrombotic Disorders - Live Q&A

Program: Education Program
Saturday, December 5, 2020: 7:30 AM-8:15 AM

Description:
Laboratory assessment of hemostatic and thrombotic disorders is a diverse and changing field. Because disorders involving bleeding and clotting range from complex, multisystem disorders, to monogenic disorders of a single coagulation factor, the diagnosis of these disorders can be difficult and time consuming. In this session, we will address three common modern conundrums in laboratory testing of hemostatic and thrombotic disorders and discuss the challenges and novel techniques developing to meet these challenges.

Dr. Johanna Kremer Hovinga will discuss the diagnosis of microangiopathic hemolytic anemia starting with the determination of schistocytes on the peripheral blood smear in the setting of thrombocytopenia as the key findings in all forms of thrombotic microangiopathy. She will then summarize key features of patient history and standard laboratory tests which can be used to make a first evaluation and describe specialized testing that can be used to establish the final diagnosis and to guide treatment and follow-up.

Dr. Michele Lambert will then discuss the current efforts ongoing to standardize and improve reporting of genetic variants and determine pathogenicity of novel genes in the hereditary hemorrhagic, thrombotic and platelet disorders. She will summarize efforts by ClinGen and the role of the American Society of Hematology and the International Society of Thrombosis and Haemostasis to drive standardization of terminology and reporting.

Dr. Rita Selby will introduce and briefly describe viscoelastic (VE) assays in hemostasis which includes both Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) assays, comparing them to standard laboratory based routine hemostasis assays. She will discuss the evidence supporting TEG and ROTEM in common clinical scenarios requiring assessment of hemostasis and management guidance. She will outline strategies by which clinicians and the hemostasis laboratory can work collaboratively to successfully implement this testing at point of care or in the laboratory, based on clinical need, and will discuss appropriate institutional based algorithms, quality assurance and cost.

Chair:
Michele P. Lambert, MD, Children's Hosp. of Phila.
Disclosures:
Lambert: Rigel: Consultancy, Honoraria, Research Funding; Aztra Zeneca: Research Funding; Dova: Consultancy, Honoraria; Novartis: Consultancy, Honoraria, Research Funding; Shionogi: Consultancy, Honoraria; Principia: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; PDSA: Membership on an entity's Board of Directors or advisory committees, Research Funding; RDMD: Membership on an entity's Board of Directors or advisory committees; 22qSociety: Membership on an entity's Board of Directors or advisory committees; Octapharma: Consultancy, Honoraria, Research Funding.
Panelists:
Johanna A Kremer Hovinga Strebel, Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern , Michele P. Lambert, MD, Children's Hosp. of Phila. and Rita Selby, MBBS, FRCPC, University Health Network and Sunnybrook Health Sciences Centre
Disclosures:
Kremer Hovinga Strebel: Roche: Speakers Bureau; Siemens: Speakers Bureau; SHIRE/TAKEDA: Membership on an entity's Board of Directors or advisory committees, Other: advisory board, Research Funding; CSL Behring: Speakers Bureau; Shire/Takeda: Other: Advisory Board, Research Funding; Ablynx/Sanofi: Membership on an entity's Board of Directors or advisory committees, Other: advisory board, Speakers Bureau; Ablynx/Sanofi: Other: Advisory Board, Speakers Bureau. Lambert: 22qSociety: Membership on an entity's Board of Directors or advisory committees; Dova: Consultancy, Honoraria; RDMD: Membership on an entity's Board of Directors or advisory committees; Principia: Consultancy, Honoraria; Shionogi: Consultancy, Honoraria; Rigel: Consultancy, Honoraria, Research Funding; Aztra Zeneca: Research Funding; Octapharma: Consultancy, Honoraria, Research Funding; Amgen: Consultancy, Honoraria; PDSA: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Consultancy, Honoraria, Research Funding.
Laboratory assessment of hemostatic and thrombotic disorders is a diverse and changing field. Because disorders involving bleeding and clotting range from complex, multisystem disorders, to monogenic disorders of a single coagulation factor, the diagnosis of these disorders can be difficult and time consuming. In this session, we will address three common modern conundrums in laboratory testing of hemostatic and thrombotic disorders and discuss the challenges and novel techniques developing to meet these challenges.

Dr. Johanna Kremer Hovinga will discuss the diagnosis of microangiopathic hemolytic anemia starting with the determination of schistocytes on the peripheral blood smear in the setting of thrombocytopenia as the key findings in all forms of thrombotic microangiopathy. She will then summarize key features of patient history and standard laboratory tests which can be used to make a first evaluation and describe specialized testing that can be used to establish the final diagnosis and to guide treatment and follow-up.

Dr. Michele Lambert will then discuss the current efforts ongoing to standardize and improve reporting of genetic variants and determine pathogenicity of novel genes in the hereditary hemorrhagic, thrombotic and platelet disorders. She will summarize efforts by ClinGen and the role of the American Society of Hematology and the International Society of Thrombosis and Haemostasis to drive standardization of terminology and reporting.

Dr. Rita Selby will introduce and briefly describe viscoelastic (VE) assays in hemostasis which includes both Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) assays, comparing them to standard laboratory based routine hemostasis assays. She will discuss the evidence supporting TEG and ROTEM in common clinical scenarios requiring assessment of hemostasis and management guidance. She will outline strategies by which clinicians and the hemostasis laboratory can work collaboratively to successfully implement this testing at point of care or in the laboratory, based on clinical need, and will discuss appropriate institutional based algorithms, quality assurance and cost.

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