- 1lab Complete Blood Count with Differential
Baseline cytopenia assessment and ongoing monitoring of myelosuppression.
- 2lab Peripheral Blood Smear (manual review)
Морфологія еритроцитів, лейкоцитів, тромбоцитів — детекція бластів, dysplasia, schistocytes, abnormal lymphoid forms; обов'язково при будь-якій незрозумілій цитопеnoї або leukocytosis.
- 3lab Comprehensive Metabolic Panel
Електроліти (Na, K, Cl, HCO3), креатиnoн + BUN (renal function), глюкоза, кальцій, альбумін, total protein. Базова метаболічна оцінка перед будь-якою терапією + основа TLS risk + dosing adjustments.
- 4lab Liver Function Tests
Assess hepatic function — baseline + during BR cycles + DAA therapy + HBV reactivation monitoring.
- 5lab Lactate Dehydrogenase
Tumor burden surrogate; rising LDH suggests transformation or progression in indolent lymphoma.
- 6lab Serum Uric Acid
Baseline перед cytoreductive therapy + TLS (tumor lysis syndrome) risk assessment. Elevated uric acid + high tumor burden → TLS prophylaxis (allopurinol / rasburicase).
- 7lab Coagulation Panel (PT/INR, aPTT, Fibrinogen)
Pre-biopsy assessment + DIC screen + baseline перед anticoagulant-affected procedures. Обов'язково перед excisional/core biopsy + bone marrow.
- 8lab D-Dimer
Маркер фібринолізу. При гематологічному workup — DIC suspect (особливо APL), VTE risk, тромботичno ускладнення MPN.
- 9lab Hepatitis B Serology Panel
Mandatory before any anti-CD20 therapy or rituximab-containing regimen — identify HBV reactivation risk.
- 10lab HCV Antibody (Anti-HCV)
Скриnoнг на HCV. Якщо позитивний → confirm з HCV RNA quantitative (TEST-HCV-RNA). Mandatory для лімфомного workup (HCV-associated MZL, B-cell lymphomas) і перед anti-CD20.
- 11lab HIV Serology (HIV-1/2 Ab + p24)
Mandatory baseline для будь-якого пацієнта з лімфомою (HIV-associated lymphomas — DLBCL, Burkitt, primary CNS), цитопеnoями неknownго генезу. Впливає на treatment intensity + ART continuation.
- 12lab CMV Serology (IgG + IgM)
Baseline CMV status — критично перед alloHSCT planning, важливо для immunocompromised patient management. У standard hematology workup — recommended перед CD20-depleting therapy.
- 13imaging Echocardiography (TTE) with LVEF assessment
Baseline LVEF + cardiac structure перед anthracycline-containing chemotherapy + alloHSCT planning. Mandatory перед R-CHOP, ABVD, doxorubicin-based regimens.
- 14lab Beta-HCG (Pregnancy Test)
Mandatory screen у childbearing-age жінок перед cytotoxic / teratogenic therapy + перед PET-CT, certain imaging. Більшість chemotherapy схем teratogenic.
- 15histology Bone Marrow Aspirate (cytology + flow + cytogenetics + molecular)
Cytologic + immunophenotypic + cytogenetic + molecular characterization. Mandatory у acute leukemia, MDS, MM, MPN. Often combined з trephine (BMAT). Provides material для multiple downstream tests.
- 16histology Bone Marrow Trephine Biopsy (Core)
Architecture + cellularity + fibrosis grade (важливо у MPN/PMF) + IHC for staging lymphomas (15-20% NHL з marrow involvement). Component of bone marrow study (зазвичай combined з aspirate).
- 17histology Flow Cytometry (Immunophenotyping)
Immunophenotypic characterization of leukocytes — discriminates lymphoid vs myeloid lineage, B vs T vs NK, mature vs immature, monoclonal vs reactive. Mandatory у acute leukemia + lymphoma + MDS + MPN workup.
- 18other Conventional Cytogenetics (Karyotype)
Detect chromosomal aberrations: t(9;22) CML, t(15;17) APL, t(8;14) Burkitt, complex karyotype (poor prognosis у MDS/AML/MM). Mandatory у acute leukemia + MDS + MM workup.
- 19other FISH Panel (disease-specific)
Targeted detection of recurring translocations / deletions. Disease-specific panels: MM (del 17p, t(4;14), t(14;16), 1q gain, del 1p); AML (PML-RARα, RUNX1-RUNX1T1, CBFB-MYH11, MLL); CLL (del 11q, del 13q, del 17p, trisomy 12); MPN (BCR-ABL); lymphoma (MYC, BCL2, BCL6 break-apart).
- 20other NGS Myeloid Panel (AML/MDS/MPN)
Targeted next-generation sequencing for: FLT3 (ITD, TKD), NPM1, IDH1/IDH2, CEBPA, RUNX1, TP53, ASXL1, DNMT3A, TET2, SRSF2, U2AF1, JAK2, CALR, MPL, KIT (D816V). Determines risk stratification + targeted therapy eligibility (FLT3i, IDH1i, IDH2i, midostaurin, etc.).
- 21histology Tissue biopsy + IHC panel + ancillary molecular
Acute leukemia diagnosis вимагає quantitation of blasts (≥20% marrow blasts per WHO 2022) + lineage assignment via flow + cytogenetic/molecular для risk stratification + targeted therapy eligibility. APL suspicion (DIC + promyelocytes on smear) — medical emergency, ATRA initiation за clinical suspicion перед cytogenetic confirmation.
Biopsy preferred: Bone marrow aspirate + trephine biopsy (posterior iliac crest); peripheral blood concurrent (often diagnostic if circulating blasts >20%)
IHC baseline: MPO, TdT, CD34, CD117, HLA-DR, CD13, CD33, CD19, CD3