- 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 цитопенії або leukocytosis.
- 3lab Comprehensive Metabolic Panel
Електроліти (Na, K, Cl, HCO3), креатинін + 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 Serum + Urine Protein Electrophoresis with Immunofixation
Detect monoclonal protein (M-spike). Mandatory: будь-який unexplained anemia + hypercalcemia + bone pain + renal failure + neuropathy. Diagnostic core MM/MGUS/Waldenström.
- 10lab Quantitative Immunoglobulins (IgG, IgA, IgM)
Hypogammaglobulinemia (CLL, MM, post-rituximab) → infection risk; hypergammaglobulinemia (chronic infections, autoimmune); monoclonal spike screening parallel до SPEP.
- 11lab Serum Free Light Chains (Kappa, Lambda, Ratio)
Detect light chain only myeloma + AL amyloidosis (where SPEP/UPEP normal). Mandatory у MM workup; abnormal FLC ratio (<0.26 or >1.65) is myeloma-defining criterion (per IMWG).
- 12lab Beta-2 Microglobulin
Prognostic marker для MM (component of R-ISS staging) + lymphomas (FLIPI for follicular). Reflects tumor burden + renal function.
- 13lab Hepatitis B Serology Panel
Mandatory before any anti-CD20 therapy or rituximab-containing regimen — identify HBV reactivation risk.
- 14lab HCV Antibody (Anti-HCV)
Скринінг 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.
- 15lab HIV Serology (HIV-1/2 Ab + p24)
Mandatory baseline для будь-якого пацієнта з лімфомою (HIV-associated lymphomas — DLBCL, Burkitt, primary CNS), цитопеніями невідомого генезу. Впливає на treatment intensity + ART continuation.
- 16imaging Whole-Body MRI (or low-dose whole-body CT)
Skeletal survey для multiple myeloma — replaces traditional radiographic survey. Detects ≥1 focal lytic lesion (myeloma-defining event per IMWG). Per IMWG 2014/2024 — WB-MRI / WB-CT / PET-CT preferred over plain X-ray.
- 17imaging 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 доступніша для початкового workup.
- 18imaging Echocardiography (TTE) with LVEF assessment
Baseline LVEF + cardiac structure перед anthracycline-containing chemotherapy + alloHSCT planning. Mandatory перед R-CHOP, ABVD, doxorubicin-based regimens.
- 19lab Beta-HCG (Pregnancy Test)
Mandatory screen у childbearing-age жінок перед cytotoxic / teratogenic therapy + перед PET-CT, certain imaging. Більшість chemotherapy схем teratogenic.
- 20histology 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.
- 21histology 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).
- 22histology 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.
- 23other 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).
- 24other 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.
- 25histology Tissue biopsy + IHC panel + ancillary molecular
Biopsy preferred: Bone marrow aspirate + trephine biopsy (≥10% clonal plasma cells confirms plasma cell dyscrasia)
IHC baseline: CD138, CD38, kappa, lambda, CD56, CD117