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NHLS Haematology diagnostic service

GENERAL INFORMATION:

The Division of Haematology provides a comprehensive routine haematology laboratory diagnostic service to GSH, Red Cross Children’s Hospital and outlying hospitals/clinics. Specialised tests for the diagnosis and monitoring of benign and malignant haematological diseases are offered. We also receive samples and provide a diagnostic service from many external NHLS laboratory locations.

The laboratory is accredited to a high standard, aligning with international quality measures, by the South African National Accreditation System (SANAS ).

The GSH laboratory receives samples from about 300 local and peripheral locations, including those in terms of memorandums of agreements, as well as private laboratories and clinics. More than 100 clinics and hospitals refer samples for ante-natal or antiretroviral (ARV) testing including tertiary centres from regional laboratories e.g., the Garden Route and the Eastern Cape (Knysna, Port Elizabeth and East London). In addition, this laboratory regularly receives referral material for flow cytometry from the Eastern Cape, hospitals in Namibia and the private sector. The molecular service receives samples from state health facilities from the Western Cape, Eastern Cape and KwaZulu Natal, as well as the private sector.

There is an ongoing effort to further improve the diagnostic service and the repertoire of tests on offer.

Haematology technologists and A/Prof J. Opie at NHLS diagnostic laboratory, Groote Schuur Hospital 

NHLS Diagnostic Laboratory (C17 - GSH):

The C17/GSH Haematology Laboratory offers a 24 hours/a day diagnostic service to GSH, as well as to some peripheral hospitals such as Mowbray Maternity, Victoria Hospital and False Bay Hospitals. This includes testing of full blood counts, white blood cell differential counts and routine coagulation testing. 

Antenatal testing for red cell blood groups and serum antibodies is performed for numerous obstetric units.

Specialised tests include:

  • Bone marrow biopsies:  Cytological and histological examination are performed for the investigation, diagnosis and follow-up of haematological malignancies, cytopenias and cytoses.
  • Flow cytometry: for the diagnosis and monitoring of  leukaemias and lymphomas, for CD34 cell counting prior to stem cell transplantation, and for diagnosis Paroxysmal Nocturnal Haemoglobinuria (PNH) clones.
  • Testing of patients with bleeding disorders including those with Haemophilia, von Willebrand’s disease and factor inhibitors.
  • Testing for the Lupus Anticoagulant
  • Testing for inherited clotting disorders (see molecular tests)
  • Testing of patients for haemoglobinopathies such as Sickle Cell Anaemia and Thalassaemia using high performance liquid chromatography (HPLC).
  • Testing for haematological malignancies; molecular testing by PCR is offered for Chronic Myeloid Leukaemia (BCR-ABL), other myeloproliferative disorders (JAK2) and Acute Promyelocytic Leukaemia (PML-RARA).
  • Platelet function analysis using the PFA-200 analyser
  • Screening for anti-PF4 antibodies which play a role in Heparin-induced Thrombocytopenia (HIT)

Further tests are regularly becoming available.

Molecular tests available:

JAK2V617F Chronic Myeloproliferative Disorder (Ph negative) confirmatory test
CALR and MPL mutations Chronic Myeloproliferative Disorder (Ph negative) confirmatory test
BCR/ABL p190 and p210 qualitative assay Diagnostic Chronic Myeloid Leukemia (CML) assay
BCR/ABL p210 quantitative assay Monitoring of CML patients
ABL kinase mutation detection assay Assessment of treatment resistance mutations in CML patients
PML/Raralpha detection assay Diagnosis and monitoring disease in Acute Promyelocytic leukemia (APL) patients
FLT3 ITD detection assay Prognostic assay for Acute Myeloid Leukemia patients with normal cytogenetics
Factor V leiden/Prothrombin/MTHFR point mutation assay Inherited Thrombosis risk factors