The Hematological Laboratories

The Hematological Laboratories of the Pediatric Hemato-Oncology Department are located in the Institute of Hematology.

The lab has units:

1. The CBC (complete blood count) room provides services to the entire hospital and to the hematology clinics.

2. Blood Counts Three automated blood count apparati (Technicon H-2, Coulter STKS, TOA system 8000N) are located at the Hematology Institute and are accessible on a 24-hour basis.

   • Two machines perform automated blood differential counts. A manual differential count is carried out when required.

3. The Immunophenotyping Unit: This laboratory provides state-of-the-art immunophenotyping analysis of various hematopoietic malignancies as well as pediatric solid tumors. The laboratory is equipped with a modern FACS (PROFILE II-COULTER), a fluorescence microscope and a cryocut for the analysis of frozen tumor sections by the Immuno-Enzymatic technique. Each new case of Leukemia, Lymphoma or pediatric solid tumor is studied by a variety of monoclonal antibodies. This is in addition to the routine analysis by cytochemistry. The FACS also supplies the DNA content measurement of malignant cell populations, as well as the percentage of CD34 positive cells for use in BM transplants.

4. The Transplant Laboratory is in charge of processing and freezing the stem cells for use in bone marrow transplants. Bone marrow, peripheral and cord blood stem cells all are processed and used in autologous as well as allogeneic bone marrow transplants. Positive purging of CD34+ cells is done routinely in cases of transplantations from mismatched related donors.

5. The Cytogenetics Unit deals with:

   • Classic Karyotyping of hematologic and solid malignancies 

   • FISH (fluorescent in situ hybridization) for the detection of chromosomal translocations and numerical aberrations in Leukemias and Lymphomas.

   • SKY (Spectral Karyotyping 

6. The Immunology Laboratory performs assays of complement, immunoglobulin fractions and of the activity of NK and LAK cells.

7. The Classic Hematology Laboratory studies:

   • Enzymology of RBC and WBC using biochemical measurements of a number of enzymes such as G6PD, Aldolase and PK

   • Hemoglobinopathies

8. The Molecular Biology Laboratory performs the state-of-the-art diagnostic procedures of relevance to the hematological and oncological clinical practice.

9. The assays available include:

   • Southern Blotting (SB) for the identification of rearrangements of the immmunoglobulin and T cell receptor beta and gamma genes (clonality of B and T cells)

   • SB for the detection of the rearrangement of the oncogenes c-myc in Burkitt's Lymphoma and BCL2 in Follicular Lymphoma and the amplification of n-myc in Neuroblastoma

   • Microsatellites (CA repeats) by the polymerase chain reaction (PCR) for the follow-up of engraftment and minimal residual disease after allogeneic BMT

   • RT-PCR of translocations BCR-ABL, PML-Rara, t(12;21), t(8;21)

   • PCR for the detection of the Ashkenazi mutation in Fanconi's Anemia and Bloom's Syndrome

   • Coagulation Tests: 

   • The Coagulation Laboratories perform all routine coagulation studies such as PT, PTT, TT, fibringen, FSP, di-dimers, bleeding time, individual clotting factors, platelet aggregation tests, protein C, protein S, AT III, plasminogen activator inhibitors circulating anticoagulants, anticardiolipin, as well as basic research of the molecular basis of Hemophilia, von-willebrand, etc.

10. Blood Bank: The Blood Bank headed by Dr. Mathilda Mandel serves the adult and pediatric population of the hospital. Every year, 18,000 blood units (1/3 whole blood, 2/3 packed cells), 6,000 plasma units and 6,000 platelet units are administered. All routine testing is performed on the premises including ABO and Rh typing, antibody screen and cross matching, VDRL, Hepatitis B, Hepatitis C, HIV, CMV, identification of antibodies, and different counts tests. Other services include auto-transfusion, usage of cell saver in o.r. during cardiac and vascular surgery, therapeutic blood drawing and organ transplant blood tests. We have two Spectra (COBE) machines and use them for peripheral stem cell collection, Leukopheresis, Thrombopheresis and Plasmapheresis. Furthermore, therapeutic plasma exchange and separation of mononuclear cells mainly for the project of peripheral stem cell collection is done, and support is provided in addition to autologous BMT.

4. The Transplant Laboratory is in charge of processing and freezing the stem cells for use in bone marrow transplants. Bone marrow, peripheral and cord blood stem cells all are processed and used in autologous as well as allogeneic bone marrow transplants. Positive purging of CD34+ cells is done routinely in cases of transplantations from mismatched related donors.

5.The Cytogenetics Unit deals with:

Classic Karyotyping of hematologic and solid malignancies 
FISH (fluorescent in situ hybridization) for the detection of chromosomal translocations and numerical aberrations in Leukemias and Lymphomas.
SKY (Spectral Karyotyping)

6.The Immunology Laboratory performs assays of complement, immunoglobulin fractions and of the activity of NK and LAK cells.

7.The Classic Hematology Laboratory studies:

Enzymology of RBC and WBC using biochemical measurements of a number of enzymes such as G6PD, Aldolase and PK
Hemoglobinopathies

8.The Molecular Biology Laboratory performs the state-of-the-art diagnostic procedures of relevance to the hematological and oncological clinical practice.
The assays available include:

Southern Blotting (SB) for the identification of rearrangements of the immmunoglobulin and T cell receptor beta and gamma genes (clonality of B and T cells)
SB for the detection of the rearrangement of the oncogenes c-myc in Burkitt's Lymphoma and BCL2 in Follicular Lymphoma and the amplification of n-myc in Neuroblastoma
Microsatellites (CA repeats) by the polymerase chain reaction (PCR) for the follow-up of engraftment and minimal residual disease after allogeneic BMT
RT-PCR of translocations BCR-ABL, PML-Rara, t(12;21), t(8;21)
PCR for the detection of the Ashkenazi mutation in Fanconi's Anemia and Bloom's Syndrome
Coagulation Tests: 
The Coagulation Laboratories perform all routine coagulation studies such as PT, PTT, TT, fibringen, FSP, di-dimers, bleeding time, individual clotting factors, platelet aggregation tests, protein C, protein S, AT III, plasminogen activator inhibitors circulating anticoagulants, anticardiolipin, as well as basic research of the molecular basis of Hemophilia, von-willebrand, etc.

9.Blood Bank:
The Blood Bank headed by Dr. Mathilda Mandel serves the adult and pediatric population of the hospital. Every year, 18,000 blood units (1/3 whole blood, 2/3 packed cells), 6,000 plasma units and 6,000 platelet units are administered. All routine testing is performed on the premises including ABO and Rh typing, antibody screen and cross matching, VDRL, Hepatitis B, Hepatitis C, HIV, CMV, identification of antibodies, and different counts tests. Other services include auto-transfusion, usage of cell saver in o.r. during cardiac and vascular surgery, therapeutic blood drawing and organ transplant blood tests. We have two Spectra (COBE) machines and use them for peripheral stem cell collection, Leukopheresis, Thrombopheresis and Plasmapheresis. Furthermore, therapeutic plasma exchange and separation of mononuclear cells mainly for the project of peripheral stem cell collection is done, and support is provided in addition to autologous BMT.