HAEMATOLOGY DEPARTMENT

Core Haematology
Specialist Haematology and Haemostasis
Surface Markers
Cytogenetics

The discipline encompasses a comprehensive range of diagnostic and clinical services covering all blood cell and coagulation disorders. The diagnostic and clinical services are closely related. The expertise and equipment available within the laboratory enables the unit to contract for and provide for special projects.

Core Haematology

The Core Haematology section uses advanced Coulter GEN-S technology and processes up to 900 complete blood counts per day; these modern analysers assure a prompt, reliable and cost effective service. Expert morphological assessment, comment and differential diagnoses are provided by medical laboratory scientists technologists, registrars and six consultant haematologists.

A consultative service is available for referral of blood and bone marrow analyses. A haematologist is available at all times.

Specialist Haematology and Haemostasis

The area of Specialist Haematology combines haemostasis with haematology special tests for the investigation of haemoglobinopathies, thalassaemia and haemolytic anaemia. Specimens are referred from throughout New Zealand.

The Haemostasis section provides an extensive range of tests for the investigation of bleeding and thrombotic disorders. This specialist section is the referral centre for many hospital and private laboratories throughout New Zealand. A close link with other specialist laboratories in Australasia is maintained via the Australasian Society of Thrombosis and Haemostasis. The comprehensive repertoire of coagulation tests supports the Haemostasis Service in its clinical programme of bleeding and thrombotic disorder management, including clinical trial work.

The Haematology Special Tests section offers a full range of testing for the diagnosis of common inherited red cell disorders. A full haemoglobinopathy and thalassaemia screening service is provided along with the provision of patient information pamphlets and patient cards. Close liaison is retained with the Molecular Pathology section of Canterbury Health Laboratories allows a full and complete diagnosis to be made.

The section also provides haemopoietic stem cell processing and quality assessment of stem cell products to the South Island Bone Marrow Transplant Unit via contract to the New Zealand Blood Service(NZBS). A full allogenic and autologous processing service is provided which includes cord blood and bone marrow collection, red cell and plasma depletion processes and CFU-GM assay.

Surface Markers

The Surface markers department utilises flow cytometry technology for the detection and classification of leukaemia and lymphoma. The analysis forms part of an integrated approach incorporating morphological, immunophenotypic, cytogenetic and molecular assessment necessary for the diagnosis and management of many haematological disorders. Other tests available include CD34 analysis for stem cell transplantation, GPI linked antigen analysis for the detection of PNH, and limited platelet glycoprotein analysis. The surface markers department also looks after the administration for bone marrow aspirate and trephine samples.

Cytogenetics

The Cytogenetics section has an extensive history of relevant research, technology innovation and clinical experience. It presently offers a comprehensive specialist service to healthcare providers located in the majority of regions of the South Island and in the Bay of Plenty and Hawkes Bay regions of the North Island. Services provided include, but are not limited to the following:

Conventional karyotype analysis, including culture and analysis of:
- peripheral blood samples, foetal, skin or other tissue for a variety of clinical conditions including congenital defects, neurological and endocrine disorders, infertility, repeated spontaneous miscarriages; also well-known genetic syndromes including Down syndrome, Patau, Edwards, Klinefelters and Turners syndromes;
- bone marrows, bloods, and tumour samples from a range of different acquired malignant conditions, both haematological and solid tumour types.
- amniotic fluid for prenatal diagnosis.
Molecular cytogenetic services are currently dominated by FISH assays relevant to the diagnosis and treatment monitoring of different clinical and acquired malignancies as follows:
- micro-deletions associated with inherited clinical syndromes, including 22q11 deletion syndrome (DiGeorge/VCFS) associated with loss of the TUPLE1 locus; William’s syndrome associated with deletion of 7q11.23 encompassing the ELN gene and Prader-Willi / Angelmans syndrome associated with deletion of 15q12 and which encompasses the SNRPN locus.
- identification of acquired fusion genes associated with particular types of leukaemia, including BCR-ABL1, TEL-AML1, IGH-CCND1, MLL rearrangements, MYC rearrangements and others.
- identification of loss or gain of discrete chromosomal regions, for example loss of 13q14 (multiple myeloma) or 20q12 (myeloproliferative disease).
- identification of gene amplifications associated with aggressive malignancy, for example N-MYC amplification in neuroblastoma.
- molecular assessment of sex-mismatched allogeneic post-bone marrow or HSC transplantation.
More specialised cytogenetic tests are provided as relevant, including:
- high-resolution chromosome analysis.
- C-banding for the analysis of unusual centromeric or heterochromatic variations.

The section is undergoing a growth phase, and is committed to the establishment of a professionally managed and well equipped laboratory with efficiently streamlined systems, demonstrated by the recent installation of a comprehensive semi-automated karyotyping and image analysis system. Participation in ongoing internal and external QAP programmes of the Human Genetics Society of Australasia ensures continued quality of service. The laboratory is well staffed with a mix of scientists, technicians and medical technologists, and has hosted several students over recent years. Interested candidates should contact us for details of possible opportunities. There are active research programs on a variety of topics including development of methods to diagnose and monitor various malignancies, refinement of molecular cytogenetic methodologies, review of chromosomal changes associated with various disorders and others.

The section has strong collaborative linkages with the Christchurch School of Medicine & Health Sciences and Christchurch Hospital focussing on acquired malignancies, most particularly the leukaemias and more recently breast cancer. Research interests are targeted towards understanding more about the molecular genetic mechanisms that underlie and cause these malignancies, and the translation of relevant findings and important technology developments into the diagnostic arena. Further details of associated research can be found here.