Readers Respond

Aug. 1, 2010
Table 1 disputed
We would like to clarify information conveyed in the article “What goes around, comes around: A review of circulating tumor cells” in the April 2010 issue of MLO, particularly that which is represented in Table 1 on page 34.

Of the numerous technology platforms available for enriching and enumerating circulating tumor cells (CTCs), the authors chose to highlight three platforms (The CELLSEARCH System, CTC-Chip, and FAST). These three technologies employ similar antibodies to capture CTCs but differ significantly in the criteria used to define a circulating tumor cell. These differences in definition, not necessarily the technology used, are what account for the perceived variability in “sensitivity” in Table 1. The authors also fail to point out that only The CELLSEARCH System and its CTC definition has been validated in multiple prospective clinical trials.

In addition, new data published using CTC-Chip technology show the “sensitivity” in metastatic prostate cancer patients to be much lower than 99% (64% according to Scott et al, Sci Tran Med, March 2010) and, unexpectedly, 47% of normal individuals in the same article had high CTC levels, which raises questions about the specificity of this assay.

Finally, it is misleading to MLO readers to present a table comparing The CELLSEARCH System, which has completed numerous rigorous regulatory approvals, has been cleared for use as an IVD system, and has a global installed base, to technologies that are still in research and development. Considering CTC platforms, particularly for use in patient management, requires careful consideration of accuracy, precision, and reproducibility of results. Thank you
for the opportunity to clarify these key points in current and developing CTC technologies.

—David Wright, MD, Pathologist
Abington Health Lansdale Hospital
Lansdale, PA

—Meredith Unger, PhD
Scientific Affairs Director
Veridex LLC
Huntingdon Valley, PA

The authors would like to disclose that M. Unger is an employee of Veridex, LLC and D. Wright is a paid consultant for Veridex LLC.

Editor's note: The article's authors declined to comment. We respect Drs. Wright and Unger's position that Table 1 may have been misleading to readers.

Inquiring minds DO want to know I enjoyed the column [“Props, peeps, & pops,” MLO June 2010, page 4].  I think you did a great job of trying to use the vernacular of the young. That meant I had to look up every one of those words so I could be just as cool as you because I didn't know them all. Maybe next time you
could include a translation for the old among us.

—Jan Taborsky
Bedford, TX

“Thank you so much for the mention of CLMA in the June edition.  I had to read the editorial twice to try to figure out all you were saying … how funny!”

—C. Anne Pontius, MBA, CMPE, MT(ASCP)
President, CLMA

After I got my grandson's English/teenager dictionary, I was able to translate your latest column (not really — I understood about 85% of it without too much trouble).

—Chuck Millstein, MBA, MT(ASCP),
CLDir(NCA), Retired

Editor's note: Our brightest minds muddled through the June 2010 editorial re our trip to Las Vegas to CLMA in May. Here is a slang guide:

  • 411 = information
  • addi-paddi = attitude
  • epic fail = highest form of failure
  • fab = great
  • fam = family
  • for shizzle = for sure
  • gnarly = cool, awesome
  • hip = cool
  • janky = unsuitable, cheap
  • keep it real = to be honest
  • killed it = the very best there is
  • nab = loser
  • oh, snap = highly cool
  • owl = old wise lady
  • peeps = people
  • phat = great, awesome, the best
  • pops = profit over patient safety
  • props = respect, recognition
  • roll the dice = let things happen
  • that's whack! = when someone thinks he/she has something that is cool but it is really not cool
  • top dog's street cred = highest authority's street credibility

Digital edition of MLO makes splash
You have one of the best electronic publications that I have read. It loads quickly and is very easy to navigate. I am a paper page type of person but really like this e-publication. Thank you!

—Linda Diggelmann, MS, MT(ASC) ASQ
Iowa City, IA

Editor's note: We are hip!! Hooray!

MLO welcomes letters to the editor. We ask that you include a phone number for verification. While we prefer to publish the writer's name, we will publish a letter with “name withheld by request,” but our editorial staff must have the writer's name confirmed for our files. MLO reserves the right to edit any letter for style and length.