CORE B- PATHOLOGYThe Pathology Core is an important part of the Seattle hematopoietic stem cell transplant program, which issupported by the Adult Leukemia Center (ALC) grant and is located at the Fred Hutchinson CancerResearch Center. The core is a highly integrated group of physicians and laboratory techniciansrepresenting four disciplines. These are pathology, flow cytometry and cell sorting, polymerase chainreaction detection of malignant cell markers, and cytogenetics. The mission of the core is to provide supportnecessary for accomplishing the research goals of the transplant program. Our major focus is the detectionand identification of malignant cells, even when these are present in very small numbers. This information iscritical for successful treatment of patients with cancer. In addition, the core provides very importantinformation about how well the donor cells are populating the bone marrow and producing normal red andwhite blood cells as well as platelets for release into the blood stream. We also have very sensitive methodsfor quickly detecting infection and can evaluate tissue samples for graft-versus-host disease (GVHD) as wellas possible damage from treatment drugs or irradiation. Anatomic pathology uses standard methods inaddition to immunohistochemistry and in situ hybridization on tissue sections to diagnose infection, GVHD,relapse of malignancy or development of second tumors, and the presence and extent of chimerism(thesimultaneous presence of host and donor cells). Molecular cytogenetics uses fluorescence in situhybridization (FISH) to recognize chimerism and tumors. Molecular pathology uses PCR methods to detectminimal residual disease. Multiparameter flow cytometry with sorting provides a highly sensitive method fordetecting small numbers of abnormal cells and separating them for studies carried out by other members ofthe core.Relevance to Public Health:These methods provide key support for virtually all projects and corecomponents of the ALC transplant program. Through these efforts, we are developing improved methods forreturning cancer patients to full health and normal lives. At the same time, we are identifying ways in whichthe body defends itself, and this knowledge can be helpful in attaining the goal of cancer prevention.
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