Bulletin April 2023 Number 202

Welcome to the April Bulletin.

Spring is much needed but has been rather reluctant to arrive this year. Any time spent outdoors is certainly a happy distraction from worries, woes and turmoil from so many different sources.

Before we move to the celebratory July Bulletin planned for the 75th anniversary of the NHS, it is the perfect time for us to explore ‘The science behind the cure’ as the current theme for this issue. We have some excellent articles on the scientific basis for gene therapy in haemophilia (p 830) and the key challenges and exciting developments in myeloma diagnosis and therapy (p 833). Cedric Ghevaert and Rebecca McDonald describe the truly groundbreaking RESTORE study with the first human trials of transfusion of red cells developed in vitro (p 836). Antibiotics have been a modern success story, but antimicrobial resistance has emerged as the sting in the tail. Dame Sally Davis, UK Antimicrobial Resistance Special Envoy to the UN, outlines the importance of this topic that now demands our attention and input (p 839).

Pursuing the latter thread further, we should certainly be concerned about the emergence of resistance to antifungal drugs, particularly in the care of neutropenic and other immunocompromised patients susceptible to opportunistic fungal infections. The World Health Organization (WHO) Global Action Plan on Antimicrobial Resistance accordingly recommends reviewing fungal pathogens and their treatment. Dr David Enoch and colleagues have reviewed adherence to prescribing and monitoring standards for liposomal amphotericin B, before and during the COVID-19 pandemic at a tertiary centre with some useful findings (p 852).

Paul Cross has highlighted that the UK is well placed to eliminate cervical cancer, with steps outlined in the WHO strategy with a combination of screening and vaccination programmes (p 842). A recent report from Jo’s Trust, based on replies from around 850 healthcare professionals, including those working in pathology laboratories delivering screening, offers insight into factors impeding progress. This concludes with a rallying call for effective change towards the elimination of cervical cancer in the UK.

We have several thoughtful reviews on meetings and conferences that members flagged as important to our current practice and future developments in pathology. A recent novel 2-day virtual symposium was held, with over 500 participants from over 40 countries critically appraising histopathology reporting practice with proposals for an alternative approach towards personalised medicine (p 860). The role of the pathologist in multidisciplinary team meetings was highlighted, together with best practices in various areas of pathology.

The 2022 UKMedLab conference was also held last November in person at the College, covering the successes of bowel screening in Scotland, laboratory data science and the challenges of effective patient engagement (p 863). The latter provoked a lively debate around the various ethical, professional and service implications.

The highly popular biennial Advances in Transfusion Medicine Symposium was held in November 2022 in collaboration with the Serious Hazards of Transfusion UK haemovigilance scheme (p 865). Over 300 delegates joined daily, including medical, nursing and scientific healthcare professionals with trainees and consultants from the UK and abroad. Evidence-based practice included liver disease and coagulopathy, trauma and paediatric transfusion with a further focus on sickle cell. Highly informative talks covered developments in CAR-T and immunotherapy, transfusion safety, new components and donor research.

A hybrid event was held in the West Midlands on diagnostic innovation, including clinical challenges, scientific development and industry engagement, with opportunities for debates, roundtable discussions and networking (p 866). 

The motto used by the College, ‘Pathology is Global’, acknowledges the hard work of the International team together with country and regional advisors in supporting around a fifth of our members who are based outside of the UK. The College was strongly represented at the 22nd Medlab Middle East and the Middle East North Africa (MENA) members’ meeting hosted at Mohammed Bin Rashid University (p 846). We are delighted again by the contribution of our trainees across the different specialties – not just to many of the articles above, but also for responding promptly as volunteers for reviewing new books (p 869). I hope you find these useful.

Finally, please do look at the excellent opportunities for wider engagement in pathology in particular during National Pathology Week in June 2023 (p 844). We will aim to report on these activities and much more as we go forth to celebrate the role of pathology in supporting patients at the very heart of the NHS as it approaches its 75th anniversary.