- 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 ESR + C-Reactive Protein
Markers of systemic inflammation. У гематологічному workup: differential diagnosis запальних vs neoplastic причин лімфаденопатії; ESR > 100 mm/h при myeloma / advanced lymphoma.
- 7lab Serum Uric Acid
Baseline перед cytoreductive therapy + TLS (tumor lysis syndrome) risk assessment. Elevated uric acid + high tumor burden → TLS prophylaxis (allopurinol / rasburicase).
- 8lab Coagulation Panel (PT/INR, aPTT, Fibrinogen)
Pre-biopsy assessment + DIC screen + baseline перед anticoagulant-affected procedures. Обов'язково перед excisional/core biopsy + bone marrow.
- 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 Quantitative Immunoglobulins (IgG, IgA, IgM)
Hypogammaglobulinemia (CLL, MM, post-rituximab) → infection risk; hypergammaglobulinemia (chronic infections, autoimmune); monoclonal spike screening parallel до SPEP.
- 13lab Beta-2 Microglobulin
Prognostic marker для MM (component of R-ISS staging) + lymphomas (FLIPI for follicular). Reflects tumor burden + renal function.
- 14imaging Contrast-Enhanced CT Chest/Abdomen/Pelvis
Initial staging imaging для більшості hematologic malignancies — лімфаденопатія mapping, organomegaly, extranodal involvement. Часто replaced by PET-CT для definitive lymphoma staging, але CECT доступnoша для початкового workup.
- 15imaging FDG PET/CT
Staging at diagnosis + response assessment after antiviral or chemoimmunotherapy. Detects transformation hotspots.
- 16histology Excisional Lymph Node Biopsy
Preferred biopsy для будь-якого suspect lymphoma — preserves nodal architecture (critical для subtyping per WHO Classification). Provides material для histology + IHC + flow + cytogenetics + molecular.
- 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.
- 18histology CD20 Immunohistochemistry
Confirm B-cell lineage and rituximab/obinutuzumab eligibility.
- 19imaging Echocardiography (TTE) with LVEF assessment
Baseline LVEF + cardiac structure перед anthracycline-containing chemotherapy + alloHSCT planning. Mandatory перед R-CHOP, ABVD, doxorubicin-based regimens.
- 20lab Beta-HCG (Pregnancy Test)
Mandatory screen у childbearing-age жінок перед cytotoxic / teratogenic therapy + перед PET-CT, certain imaging. Більшість chemotherapy схем teratogenic.
- 21histology 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.
- 22histology 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).
- 23histology Tissue biopsy + IHC panel + ancillary molecular
Архітектура лімфовузла критична для класифікації лімфоми (follicular vs diffuse, nodular vs interfollicular). FNA зазвичай недостатня — пропускає architectural pattern + не дає material для flow + IHC + cytogenetics.
Biopsy preferred: Excisional biopsy of largest accessible peripheral lymph node (axillary > cervical > inguinal)
IHC baseline: CD20, CD3, CD5, CD10, CD23, BCL2, BCL6, Ki67