Hematology

Diagnostic methods in Department Of Adult Hematology

In the hematology clinic, both standard diagnostic methods and quite specific ones are used.

Patients of the Department of Adult Hematology Maimonides Clinic have an access to modern and accurate diagnostic procedures. The main ones are:

• General and biochemical blood tests, determination of various antibodies in blood, evaluation of the blood coagulation and fibrinolytic system function etc.
• Ultrasound of organs and soft tissues, lymph nodes. Performing a puncture biopsy under ultrasound control.
• Bone biopsy and bone marrow aspiration followed by a myelogram
  is a modern method that makes it possible to diagnose a large number of blood diseases.
• Lymph node biopsy with cytological and histological examination of the biopsy spesimens.
• Immunophenotyping of blood cells and tumor cells
  is a highly informative method of verifying the diagnosis. It allows us to establish which blood cells the tumor originates from and which treatment scheme we can choose to make therapy the most effective.
• Modern methods of medical imaging are actively used in the diagnosis of hematological diseases and their complications. A doctor receives a lot of useful information with the help of digital radiography, CT, MRI, PET-CT, MSCT and their various modifications.
• Gallium scintigraphy helps to visualize the primary tumor and its metastases in the patient's body, after which they can be actively affected.
• Lumbar puncture followed by examination of the cerebrospinal fluid. It can be used in patients with suspected tumor lesions of the central nervous system in the case of some hematological diseases, lymphoma particulary.

If the diagnosis requires biopsy data (trepan bone biopsy), then such painful procedures are performed under local or general anesthesia to avoid any unpleasant feelings. Obtained material is additionally sent to the best Israeli, American, and German pathomorphological laboratories to confirm the diagnosis. Thanks to such "molecular checks" , we are absolutely sure of the diagnosis correctness and effectively selected treatment scheme.

If the Maimonides Medical Center does not have a specific specialist or diagnostic equipment, but the clinical situation requires its application, the patient is referred to affiliated medical institutions or partner clinics, where he will receive the entire necessary list of diagnostic and/or treatment procedures.

Modern treatment in The Department of Adult Hematology

The Department of Adult Hematology of the Maimonides Clinic works on the principles and model of modern Israeli medicine, so our patients have an access to all its advantages and achievements.

n recent years, extraordinary progress has been achieved in the main method of hematological oncological diseases treatment. It is bone marrow transplantation.

Before the procedure, the patient's bone marrow, which does not function properly and produces defective tumor cells, is destroyed with chemotherapy or radial therapy. After that, he is injected with healthy bone marrow from a donor(most often it is a close relative or another person who is as suitable as possible donor for a number of characteristics).Such bone marrow transplantation is called allogeneic.

After that, the donor bone marrow "takes root" in the new place and begins to function correctly and fully, thus saving its new owner from a serious and deadly disease.

Sometimes we provide autologous bone marrow transplantation. This is when the patient needs high-dose chemotherapy or radial therapy to overcome the tumor. But, unfortunately, such high doses lead to irreversible damage to bone marrow cells.

Therefore, before the course of treatment, the patient's own bone marrow is taken, and after receiving a course of chemotherapy or radiotherapy, pre-collected healthy bone marrow material is injected, which easily takes root and begins to function. This method of treatment allows us to defeat aggressive malignant diseases and at the same time bypass the severe side effect of the therapy program.

Transplantation of stem cells is an innovative method of treatment in hematology. Stem cells are taken from the bone marrow, umbilical cord blood and peripheral blood before complex treatment(chemotherapy + radial therapy)after which they are returned to the patient's bloodstream. Stem cells can be your own, or they can be donor.

Using this treatment method, it is possible to overcome up to 90% of all diseasesaccompanied by the process of hematopoietic disorders(aplastic anemia, various forms of leukemia, myelodysplastic syndrome, hereditary syndromes of bone marrow dysfunction, etc.).

Today, new generation of anticancer drugsare available to applie. For instance, therapeutic monoclonal antibodies(rituximab, alemtuzumab, zevalin, milotarg, and others), which are obtained by genetic engineering. Their main affect is the ability to selectively connect with certain types of tumor cells, activating the immune system to destroy such complexes.

Monoclonal antibodies act selectively – they damage malignant cells, at the same time, not harming other healthy cells in the body. This is their main difference from classical chemotherapeutic drugs and a considerable advantage.

CAR T-cell therapy is a modern method of treating malignant diseases of the blood system. The essence of this technique is the extraction of T-lymphocytes from patient's body with their further modification(a kind of training)so that when they return to the patient's body, they can find and destroy tumor cells. This is an innovative method of treatment that all our patients have access to.

Among different therapy methods in hematology clinic, we use applies such a procedure as blood components transfusionFor the safety of the patient scheduled on hemotransfusion, donors are carefully checked for infectious diseases that can be transmitted with blood components(viral hepatitis B and C, AID, syphilis, some other infections).

Most often, blood is transfused for refractory and severe anemia, myelodysplastic syndrome, thrombocytopenia, and some other conditions accompanied by a high risk of bleeding.

The method of "fluorescence-activated cell sorting" (FACS) s not a medical procedure, but a diagnostic method that allows us to detect and make accurate diagnoses at the initial stages of tumor development(leukemia and other lymphoproliferative diseases), as well as detect minimal residual disease.

Modern drugs for drugs that inhibit tumor cells growth and reproduction (cytostatics)are actively used in the complex treatment of onco-hematological diseases.

At the Maimonides Clinic, we use only high-quality and safe drugs for chemotherapy from proven well-known manufacturers.

For the treatment of certain lymphoproliferative blood diseases, various combinations and regimens of cytostatics are used:

• BEACOPP protocol;
• BEACOPP-esc protocol;
• BEACOPP-14 protocol;
• Stanford IV, Stanford V protocol, COPP schemes, ABVD;
• MOPP protocol;
• COPP protocol. Scheme of ChlVPP.

In each individual case, the scheme and protocol of chemotherapy and immunotherapy is selected by the doctor, based on the diagnosis, type of tumor, patient's condition, presence of accompanying health problems, response to treatment.

In The Department Of Adult Hematology Maimonides Multidisciplinary Medical Center, are used many more modern treatment methods of hematological diseases.

In our work, we pursue the following goals:

• to provide the patient with all the necessary diagnostic and treatment procedures;
• to use only modern approaches and quality standards for the provision of medical services, based on the model of modern Israeli medicine;
• create comfortable conditions for patients to stay in the clinic and ensure continuity of medical care within one medical center.