NSH Flow Cytometry and Molecular Diagnostics Laboratories, under the direction of Irina Grigorieva, PhD, perform high-complexity clinical assays by utilizing innovative equipment and progressive technologies in their 4,600 square feet facilities. They provide outstanding customer care by assisting clinicians with current ASH and College of American Pathologists recommended initial acute leukemia diagnostic work up testing, http://www.hematology.org/Newsroom/Press-Releases/2017/7155.aspx*, are able to determine disease prognostic indicators, quickly identify early relapse, and provide post treatment assessment/diagnosis.**
Both laboratories meet the requirements of CLIA, Georgia Department of Human Resources, JCAHO, and College of American Pathologists. Please click Facilities to review the laboratory-testing menu.
*Initial Diagnostic Workup of Acute Leukemia Guideline from the College of American Pathologists and the American Society of Hematology, Archives Pathology and Laboratory Medicine, Accepted December 9, 2016. This guideline was developed through collaboration between the college of American Pathologists and the American Society of Hematology.
** ASH Pocket Guide: ‘Initial Diagnostic Workup of Acute Leukemia A Pocket Guide for the Clinician’ Melissa H. Cessna, MD Intermountain Healthcare and Utah Pathology Services, Inc. Sa A. Wang, MD The University of Texas MD Anderson Cancer Center March 2017 The recommendations in this guide are based on the Initial Diagnostic Workup of Acute Leukemia, a guideline from the College of American Pathologists (CAP) and the American Society of Hematology (ASH).
Reference Laboratory Testing
The program continuously update diagnostic testing menus based on latest research. If the appropriate test is not available at Northside Hospital, the testing sample(s) are sent to accredited outside laboratories to obtain more precise information about the patient’s disease process. Identification of genetic changes, including specific gene mutations, may give us information to determine prognosis and develop effective treatment plans. Knowing the status of certain mutations is also critical for determining which patients may benefit from a blood or marrow transplant. Each patient’s treatment plan takes into account previous medical history, all diagnostic testing results and a tailored plan is developed.
Cytogenetics/Fluorescent In Situ Hybridization (FISH)
Cytogenetic analysis allows us to look for large changes in the patient’s white blood cell DNA that may be associated with their disease. FISH analysis allows us to examine the DNA for more specific changes commonly found in the patient’s type of disease. Highly trained scientists perform, review and communicate test results to our leukemia physicians.
Next Generation Sequencing
Next generation sequencing gives us a much more detailed analysis of mutations that may be involved in myeloid disorders, AML and MDS. A carefully chosen panel of genes is examined for mutations, as small as a single nucleotide change, which can help us characterize each patient’s disease process. As new research emerges, the list of gene targets increase.
The NSH Molecular Laboratory, or outside laboratory, may order additional molecular studies if necessary. Highly sensitive tests, such as Minimal Residual Disease (MRD) flow cytometry and RT-PCR assays, can detect very small amounts of MRD after treatment. Having MRD maybe a sign of relapsing disease.