The haematology service of Hematology Laboratory is integrated into the Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology and is structured as follows:
Most of the sections are coordinated in two simple Operating Units:
The Hematology service has about 500 square meters of laboratories and studios, equipped with all the necessary instruments to carry out research and diagnostics in the field of haematological diseases.
The laboratories are equipped with the most important equipment to carry out activities in the field of haematology, in particular blood cell counters, flow cytometers, ultracentrifuges, devices for gene amplification, traditional and "real-time" (quantitative PCR), nucleotide sequencer and sequencer for NGS (next generation sequencing) method, ultra-freezer, image acquisition and processing equipment, spectrophotometers, laminar flow hoods for cell separation.
All sectors operate for both in-patient and outpatient patients. In the hemocytometry and cytochemistry laboratories, about 1,000 tests are carried out daily (divided between emergencies, hospitalized patients and outpatients) organized in a centralized CoreLab and integrated with 1st level blood coagulation and chemistry tests.
The internal management system allows in real time to access any exams previously performed by patients for the purpose of checking and monitoring the patients themselves.
The results of the blood counts of the outpatients are already available from the working day following the execution of the exam.
In the morphological diagnostics section, an average of 2,500 bone marrow agospirates are analyzed every year, both from hospitalized patients and outpatients, for the diagnosis and follow-up of haemopathies and for all those other pathologies in the internal, infectious, oncological field, for which this examination is required. When necessary, suitable cytochemical stains are also performed.
In this sector, molecular hybridization tests in situ (FISH) are also performed on peripheral blood and medullary blood for the diagnosis of the main cytogenetic alterations characteristic of onco-haematological diseases.
The flow cytometry laboratory plays a fundamental role in integrating the diagnostic and prognostic framework of the main oncohematological diseases, in particular:
The biological samples on which the flow cytometric analysis is applied in our laboratory are:
The laboratory also performs the analysis of the lymphocyte subpopulations which is a very useful parameter in the diagnosis of haematological diseases and of the immune system.
The molecular biology laboratory carries out tests to identify and characterize chronic myeloproliferative diseases (clonality analysis, search for the mutation of the JAK2 V617F gene and mutations in exon 12 of the JAK2 gene, rearrangement bcr/abl, upon appointment and by appointment, search for MPL and CARL gene mutations), lymphoproliferative diseases (rearrangement of the bcl2 gene, of the immunoglobulin gene and of the T-cell receptor, search for translocation 11; 14), congenital thrombophilia (search for factor V Leiden and prothrombin G20210A, antithrombin and protein gene sequence C).
In addition, quantitative monitoring of the bcr/abl transcript and the JAK2 V617F mutation is performed for patients with chronic myeloproliferative diseases (chronic myeloid leukaemia, polycythemia vera, essential thrombocythemia and idiopathic myelofibrosis). The laboratory is in fact accredited by Labnet for the molecular monitoring of chronic myeloproliferative neoplasms.
The main diagnostic activities of the immunogenetics laboratory are the typing of patients and their relatives to search for a donor of hematopoietic stem cells, the typing of the cryopreserved cord blood units at the UNICATT Umbilical Cord Bank and the analysis of hematopoietic chimerism in patients undergoing allogeneic haematopoietic stem cell transplantation.
Since 2012 the laboratory has been accredited by the European Federation of Immunogenetics (EFI). The HLA exams performed are: HLA-A, HLA-B, HLA-C genomic typing; HLA-DRB, HLA-DQB1 and HLA-DPB1 at low and high resolution.
In the laboratory for the study of alterations in erythropoiesis and iron metabolism, the first level screening of hemoglobinopathies and thalassemia syndromes is performed with examination of the hemolysate by HPLC, integrated when necessary with the electrophoresis of hemoglobin, the search for unstable hemoglobin variants with isopropanol test, and the sickling test.
Tests are also performed for the identification of congenital or acquired haemolytic anemias (hereditary spherocytosis, paroxysmal nocturnal haemoglobinuria) and the dosage of serum erythropoietin.
Finally, the main genetic mutations most commonly responsible for hereditary hemochromatosis and beta-thalassemia are sought.
