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The Department of Pathology at St. Jude Children’s Research Hospital works behind the scenes throughout a child’s treatment journey. The department is committed to excellence in the delivery of clinical services, the advancement of biomedical research and diagnostic techniques, and the promotion of education and professional opportunities.
When a patient arrives at St. Jude, one of the first steps is to determine diagnosis as quickly as possible. Special Hematology, Molecular Pathology, Immunopathology and Cytogenetics laboratories provide testing for diagnostic and treatment-related bone marrow samples. Once testing is complete, the patient’s clinical team works with the pathologists to determine diagnosis and prognosis.
As a child undergoes treatment, Pathology tests various samples to monitor treatment response. Some of the routine testing includes a complete metabolic profile, which monitors the child’s liver, kidney and other organ functions during treatment. A complete blood count is collected almost daily to monitor the child’s treatment response, to determine if a patient has become anemic or if the child has a low platelet count, which can lead to spontaneous bleeding.
When a patient experiences issues with blood clotting, coagulation studies are performed to determine the problem. Spinal fluid analysis is used to determine if the leukemia has spread to the spinal fluid and is performed at diagnosis, periodically throughout treatment and at the completion of therapy.
Chemotherapy destroys cancer cells, but it also destroys good cells. The labs within Pathology work every day to ensure enough good cells are available to help the patient recover. If a child is determined to be anemic, or have a low platelet count, the Pathology department’s Blood Bank and Blood Donor Center step in.
St. Jude has its own Blood Donor Center dedicated to providing blood and platelet products to its patients. Every day the Blood Bank readies platelet products for 15 to 25 transfusions for children undergoing treatment. Having the center onsite cuts down on the amount of products the hospital needs to purchase from outside blood centers. Because platelets have a short shelf-life, the location of the center to the patient care areas and the Pathology labs is vital.
If a child’s count is low, the clinical team orders platelets or red blood cells. The Blood Bank then performs testing for the patient’s blood type and compatibility testing, and products are prepared for infusion.
Pathology performs complete blood counts, complete metabolic profiles and a multitude of other tests on a daily basis.
When a child nears the end of active treatment, there is one very important test. The bone marrow aspirate is done to make sure there is no sign of residual disease. If the test is clear, the St. Jude patient marks the journey’s important milestone with a No Mo Chemo Celebration. The celebration gives the patient, family and hospital staff the opportunity to recognize the great accomplishment, and it becomes a memory-making opportunity for all.
Throughout a patient’s treatment, Pathology is there each step of the way. The hope inherent in this commitment is that each element will improve a child’s quality of life.