Pathology research

Alfred Health Pathology Services incorporates Laboratory Haematology, Microbiology and Clinical Biochemistry (also known as Chemical Pathology) and Anatomical Pathology.

This year’s report focuses on Haematology. Anatomical Pathology, headed by Professor Catriona McLean, is also reported.

Laboratory Haematology is primarily a diagnostic and consultative service providing expertise in blood banking, laboratory-based general haematology, including morphology, coagulation and flow cytometry, immunology tests and diagnostic bone marrow biopsies. The unit incorporates a specialist multidisciplinary transfusion medicine team which audits transfusion safety and practice.

Research collaborations involve identifying and supplying material for various registries of the Transfusion Outcomes Research Collaborative; Australia and New Zealand Intensive Care Society’s TRANSFUSE trial; Clinical Haematology and Trauma Unit clinical trials; Australian Centre for Blood Diseases (ACBD), Australasian Leukaemia and Lymphoma Group and Nucleus Network.

Current research includes:

Development of highly sensitive flow cytometric techniques for detection of small volume minimal residual disease after potentially curative therapy, particularly in multiple myeloma and acute myeloid leukaemia (AML)
Coagulopathy associated with mechanical circulatory assist devices and heart valve dysfunction (ACBD collaboration)
PTP1B expression in myeloproliferative disorders as a marker of JAK-STAT pathway dysregulation
Haematological and biochemical complications of dapsone therapy
Predicting outcome in AML: molecular testing for founder mutations
Blood product use in bone marrow transplant and cardiac surgery patients
Pre-operative optimisation of hemoglobin in orthopedic patients to limit need for transfusion

Achievements

Dr Victoria Ling, Haematology RACP /RCPA Advanced Trainee, won the 2014 Victorian RACP Trainee Research Award for Excellence in Adult Medicine
Dr Kay Htun, Haematology RACP /RCPA Advanced Trainee, won the 2014 Alfred Hospital prize for Best Advanced Physician Trainee Project
Dr Mandy Davis, Haematologist and Transfusion Specialist, was awarded the WTMS (Whole Time Medical Specialist) grant of $56,000 for expansion of the BloodTrack program to improve safety of blood administration.

Acute Myeloid Leukaemia: predicting outcome

Disease aggressiveness and treatment responses in AML patients vary widely, despite cytogenetic prognostic categories at diagnosis broadly defining patient outcome.

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Inappropriate pre-operative testing

Studies in the UK have determined that up to 25% of pathology testing is inappropriate or unnecessary.

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Side effects of Ventricular Assist Devices (VADs)

Patients on ventricular assist devices or with some cardiac valve disorders develop bleeding complications due to the mechanical effect of shear stress on blood components.

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