This year AACC accepted 773 abstracts representing innovative scientific work from 52 countries. Although every abstract will not receive special recognition, spotlighted here are several “hidden gems” that you may want to visit during this year’s poster sessions.

Development of a reference material for the determination of vitamin B 12 in human serum.  J. E. Camara et al. Poster A-307

In America, due to the lack of vitamin B12 assay harmonization, the incidence of vitamin B12 deficiency is estimated to range from 300,000 to 3,000,000 individuals. This lack of reference material for vitamin B12 has critical clinical implications for patient care. Researchers from the National Institute of Standards and Technology developed vitamin B12 reference materials (SRM 3951) using pooled normal donor serum. The material spans three concentration levels: low, mid, and high. The availability of this reference material may be a crucial step in harmonizing vitamin B12 assays.

Performance characterization of a liver function panel on the Abaxus piccolo Xpress. W.E. Owen et al. Poster B-234

In 2014, the United States reported five confirmed cases of Ebola with one resulting in death.  This launched a nationwide review of clinical laboratory readiness during an epidemic. Clinical laboratories redefined, modified, or for the first time developed specimen (suspected or confirmed Ebola infection) processing and testing protocols. Owen and colleagues characterized the performance of the Abaxis Piccolo Xpress analyzer, specifically focusing on the liver function panel, sample type and stability, reference ranges, and instrument airflow. Method comparisons between the Roche Cobas c502/c702 analyzers and the Abaxis Piccolo Xpress demonstrated biases for alkaline phosphatase, amylase, and total bilirubin. The manufacturer reference ranges for all analytes except alkaline phosphatase and alanine aminotransferase. This study provides useful performance and validation data for clinical laboratories.

Drug excretion into breast milk: are all drugs contraindicated for breastfeeding? D. Colantonio et al. Poster A-012

The LactMed® database is a resource that is updated monthly with information on common drugs and chemicals that may be transferred to breast milk. Although this resource exists, there remains limited pharmacokinetics data on contraindicated drugs for breastfeeding mothers. Using methotrexate/metabolites as the drug of interest, the authors developed a LC-MS/MS method to quantitate methotrexate in both human foremilk and hindmilk. Breast milk samples were collected from breastfeeding mothers that received weekly subcutaneous doses of 25 mg/mL of methotrexate. The peak drug concentrations were seen between 1-12 hours post-injection. However, N differences were detected in methotrexate concentrations in foremilk or hindmilk samples. The data are important for the continued development of TDM protocols to support standardized drug safety breastfeeding guidelines.  

Is the use of pancreatitis associated protein (PAP) as a second tier in newborn screening of Cystic Fibrosis justified? I. Borovickova et al. Poster B-214

A newborn screening strategy that provides timely and accurate diagnosis of cystic fibrosis is critical for patient management.  The authors assessed the performance of three screening strategies to reduce the number of cystic fibrosis carriers detected.  They compared their current cystic fibrosis newborn screening strategy to three different strategies: one that used immunoreactive trypsinogen (IRT)/DNA with a top 0.5 percentile IRT cutoff, and two strategies that used IRT/PAP/DNA, each with different IRT and PAP cutoffs.  The 1-year prospective study analyzed 72,177 infant samples submitted to the National Newborn Bloodspot Screening Laboratory in Temple Street Children’s University Hospital, Dublin.  Compared to the other strategies tested, the IRT/PAP/DNA strategy with two IRT and two PAP concentration cutoffs exhibited a better PPV, less cystic fibrosis carriers detected (~ 50%, 1.9% compared to 0.8%), and a cost savings of €147,000 ($165,000) per 100,000 infants screened.