Flow Cytometry Laboratory

The Flow Cytometry Laboratory performs diagnostic immunophenotyping, functional analysis, cell sorting, and other flow cytometry based clinical assays for the Yale New Haven Medical Center as well as for many other institutions. Diagnostic flow cytometry is a powerful clinical tool performed for acute leukemias, lymphomas, myeloid neoplasms, paroxysmal nocturnal hemoglobinuria, immunodeficiency, and measurable residual disease monitoring, etc. Standard consultative diagnostics in this area involve coordinated "reflex" analysis of a blood, marrow, fluid, lymph node, or other tissues. Analysis of specimens begins with a clinical and morphologic review of the case by one of our clinical pathologists. Appropriate cellular interrogations are performed based on the clinical question, and interpretations are made on the basis of these aspects of the case as well as the flow cytometric findings and often the results of additional molecular and other tests.

Hematopathologists are available seven days a week to render appropriate diagnoses for ordering clinicians. The laboratory prides itself on maximizing both quality of care and cost-effectiveness for the patient, providing comprehensive, clinically useful information in the most efficient manner possible. This high volume laboratory continuously explores new techniques and is at the forefront of diagnostic medicine.

The Flow Cytometry Laboratory works closely with the Hematology Laboratory, Molecular Diagnostics Laboratory, Immunology Laboratory, and Transfusion service within the Department of Laboratory Medicine in order to optimize cross-disciplinary diagnostic activities. The Flow Cytometry Laboratory also works closely with the Pathology Department and provides training to our Pathology and Laboratory Medicine residents and fellows, as well as fellows from other departments, along with serving as part of the advanced diagnostics training for Medical Laboratory Scientist students from several universities.

New diagnosis of Acute Leukemia is available seven days a week (including final diagnostic interpretation by our clinical pathologists). Analysis is carried out in a "reflex marker" approach as appropriate to best classify the disease by lineage and subtype. Final WHO/ICC diagnosis will often include molecular testing as needed and the pathologists can offer assistance in appropriate molecular tests needed. Follow-up measurable residual disease testing or leukemia monitoring can subsequently be carried out.

Myeloid neoplasms can be evaluated by flow cytometry in order to assess both number and phenotype of blasts, as well as aberrancies in myeloid and monocytic cells. This is frequently done in combination with morphologic and molecular evaluation.

The laboratory performs analyses for T- and B-cell lymphoproliferative disease. While flow cytometry has the strength of clonality assessment of B-cells via kappa and lambda light chain restriction, T cell neoplasms such as Sezary syndrome often exhibit loss of typical T-cell antigens. The flow cytometry laboratory also performs assessment of plasma cell neoplasms, including next-generation flow cytometry for measurable residual disease evaluation of known myeloma patients.

The laboratory offers quantitative assessment of critical lymphocytes subsets and works with the Immunology laboratory to establish diagnoses in this area. Additionally, we perform specialized dihydrorhodamine (DHR) testing by flow cytometry for the evaluation of chronic granulomatous disease.