Hematology

Division of Hematology

Choosing Wisely Together

Hematology services Southwestern Ontario (Owen Sound to Windsor) and provides specialized testing for Thunder Bay, North Bay and Prince Edward Island.

It is composed of three laboratory areas each with its own specialty:

The Investigational Hematology laboratory provides diagnostic services for a variety of hematological diseases and serves as an adjunct resource to the Core Laboratory. The four main areas of expertise include:

• Bone marrow aspiration preparation and interpretation in malignant and non malignant conditions.
• Hemoglobinopathy syndrome investigation using capillary electrophoresis
• Anemia investigation and diagnosis of blood-born parasitic infections such as malaria, babesiois and filariasis
• The laboratory is a reference centre for many community hospitals within the South Western part of the province.

The Flow Cytometry laboratory offers a wide range of diagnostic testing using up to 10-color flow cytometric analysis with the following test menu:

• Hematolymphoid neoplasms (including leukemia, non Hodgkin lymphoma, myeloma, and other conditions).
• Minimal residual disease testing for acute lymphoblastic leukemia
• High resolution Paroxysmal nocturnal hemoglobinuria (PNH) testing on both WBC and RBC
• CD34 Stem and progenitor Cell Enumeration
• Fetal Maternal Hemorrhage / detection of fetal cells
• Chronic granulomatous disease (CGD) / neutrophil oxidative burst assay
• Immune monitoring including T-lymphocyte subset evaluation / CD4 count, autoimmune lymphoproliferative syndrome (ALPS).
• Acute Leukemia Triage Process

Final reports for diagnosis of possible hematological malignancy are interpreted by hematologist/hematopathologist.

The Hemostasis and Thrombosis laboratory offers the following test in coagulation:

• ADAMTS 13 Activity (ATS13) and Inhibitor testing – ATS13 is reduced in thrombotic thrombocytopenic purpura (TTP). Combined with inhibitor testing makes it possible to differentiate between congenital and acquired forms of TTP.
• Anti Thrombin 3 Assay. Reduced concentration of ATIII in blood means a great and well established risk for thrombotic complications
• APC Resistance Assay. An APTT-based screening assay will detect this abnormality and the specific genetic testing can then performed.
• Factor Assays. Both intrinsic and extrinsic assays are performed. Reduced levels of factor assays can lead to mild or major bleeding conditions.
• Factor Inhibitors. Patients who develop an antibody against a specific clotting factor are said to have an acquired factor inhibitor.
• Heparin Assay. Low-molecular weight heparin (LMWH) and danaparoid (Orgaran®), when present at therapeutic levels, usually do not significantly prolong the activated partial thromboplastin time (PTT). Therefore, when laboratory tests are used to monitor therapeutic anticoagulant levels of LMWH or danaparoid, antifactor Xa assays are necessary.
• Heparin Induced Thrombocytopenia Assay. Patients with this disorder are receiving heparin therapy and develop antibodies to antigens on platelets.
• Hypercoagulable Screen. Includes Lupus anticoagulant (LA), Protein C and Protein S levels. Patients with LA, or C and or S deficiency have a higher incidence of recurrent venous thrombosis and/or pulmonary embolism

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