Peyvand Laboratory - بخش سلول درمانی و پیوند سلول های بنیادی خونساز

About Peyvand laboratory

Peyvand laboratory consists of four specialized departments including molecular laboratory, flow cytometry, HLA-typing and cell culture laboratory.

In this complex, in addition to providing clinical services to patients, the available facilities are used to conduct research projects, student theses and hold educational workshops in the fields related to stem cell transplantation.

Types of samples and work process

After review and interpretation, the results obtained from the investigations are provided to the clinical colleagues as soon as possible (24 hours if possible). In the flow cytometry laboratory, in addition to the diagnosis and monitoring of blood malignancies, the investigation of immunodeficiency diseases and pernicious nocturnal hemoglobinuria (PNH) is performed. Another unique service of the transplant laboratory is HLA-typing.

In this department, by receiving 2 ml of blood from the patient and a suitable relative for stem cell donation, the DNA of the cells is extracted and performed using quantitative QTYPE kits and LightCycler® 480 Roche device with 384 plate and the capacity to perform HLA-Typing 11 loci and 6 loci. The interpretation of the results of this section is done by hematology and genetics professors, and if there is no similarity between the recipient and the relative donors, the HLA bank of Iran and the world is examined to find a suitable donor.

Samples sent to BMT laboratory include the following:

Bone Marrow Aspiration (BMA)

Bone marrow aspiration is a method of collecting and analyzing bone marrow (spongy tissue inside some large bones). A bone marrow aspiration indicates

Peyvand Laboratory Bone marrow transplant laboratory آسپیراسیون

whether the bone marrow is healthy and making enough blood cells or not.

medicines specialists analyze the bone marrow aspiration to diagnose and treat blood and bones marrow disorders, such as Leukemia and lymphomas.

To perform aspiration, the doctor makes a small incision to make it easier to insert the needle. A needle is inserted through the bone into the bone marrow.

The sample (for all tests) must be sent to the laboratory in a tube containing EDTA anticoagulant and under the condition of keeping the cold chain. (If the sample is sent from other cities, the cold chain must be maintained and finally the sample must be delivered to the laboratory up to 24 hours after sampling. Also, freezing of the sample must be prevented, freezing or heat causes death. and the loss of morphology and protein markers of blood cells).

Peripheral blood sample (PB)

Peripheral blood or whole blood has many blood cells that include erythrocytes (red blood cells), leukocytes (white blood cells) and platelets and

Peripheral Blood-PB Peyvand Laboratory Bone marrow transplant laboratory

which are soluble in plasma. In general, the main component of plasma is water, but proteins, glucose, ions, hormones and Coagulation factors are also among its components.

Peripheral blood is sent to the bone marrow transplant laboratory for the diagnosis and follow-up of blood disorders and blood malignancies, as well as the HLA-Typing molecular test for the bone marrow transplant process.

The sample should be sent to the laboratory in the same way as the bone marrow aspirate sample, inside the tube containing EDTA anticoagulant and under the condition of keeping the cold chain. (If the sample is sent from other cities, the cold chain must be maintained and finally the sample must be delivered to the laboratory up to 24 hours after sampling. Also, freezing of the sample must be prevented, freezing or heat causes cell death and loss of morphology and protein markers of blood cells).

Pleural fluid

Pleural fluid or pleural fluid is the fluid between the layers of the pleura. Pleura is a double-layered membrane that covers the lungs and contains the chest cavity. The pleural fluid keeps the space of these membranes moist and helps to reduce the friction between the membranes during breathing. This liquid can be contaminated in some blood malignancies due to the metastasis of malignant cells, so if the doctor suggests the possibility of metastasis, a sample is taken and sent. Sampling should be done in such a way that the sample is not contaminated with peripheral blood.

The cold chain must be followed until the sample is sent to the laboratory. Also, freezing of the sample should be avoided, freezing or heat causes death and loss of morphology and protein markers of blood cells.

Procedures for accepting samples in the bone marrow transplant laboratory:

Received samples must contain a prescription from a specialist doctor. A copy of a part of the patient medical records that include the history of previous diagnosis or reports of clinical tests, including radiography, radiology, laboratory test results, should be given to reception of laboratory. Also, if necessary, the history is received by the relevant colleagues from patient

doctor.

Patients who referred for HLA-typing test are divided into two groups:

A. People who have referred as bone marrow transplant candidates or targeted relative donors.

B. People who volunteer to donate stem cells.

Peripheral blood samples are taken from both groups, and the required information and history are taken from the experimenter by the relevant colleague. The sample must meet the necessary conditions for acceptance. In none of the tests, there is no need for special conditions before sampling. (It does not require fasting.)

Cases of non-acceptance of samples:

• A sample that is transferred in an inappropriate transfer condition.

• Mislabeled or unlabeled samples

• Insufficient sample size

• Delay in bringing the sample to the laboratory after aspiration.

• All samples should be sent in a tube containing EDTA anticoagulant.

• All the samples, except the peripheral blood sample, are taken and sent by the doctor. If the peripheral blood sample is not taken by the doctor, it will be taken from the patient by the laboratory personnel.

Storage conditions: after sampling, the sample should be analyzed in the shortest possible time. The sample can be kept in the refrigerator until testing.

آزمایشگاه پیوند REAL TIME PCR ریل تایم پی سی آر ژ«تیک مولکولی آژمایش ژنتیک مولکولی

The isolation process must be performed in completely sterile conditions and by an experienced staff, because it is of great importance in the treatment process and any disruption in this process will cause contamination, loss of CD34+ stem cells, etc.

In the stem cell transplant laboratory, in order to improve the level of service and make the needs of patients accessible, Graft manipulation procedures have been carried out since the beginning of the department’s establishment.

The cell culture laboratory has been recently launched with the aim of meeting the needs of professors, students and researchers. This laboratory is equipped with a clean room with all the necessary culture equipment, including laminar class hood, CO2 incubator, centrifuge, optical and invert microscope, autoclave, and nitrogen tank.

In addition to the facilities and equipment mentioned above, this center is equipped with a cold room to store research samples in standard temperature conditions until testing.

Picture Gallery

Peyvand Laboratory members

Laboratory Technicians

Dr. Mohammad Hossein Mohammadi
Peyvand Laboratory Technical Supervisor

Dr. Elham Roshandel, Ph.D. in hematology and technical manager of transplant laboratory

Dr. Elham Roshandel,Ph.D. hematology
Peyvand Laboratory Technical Supervisor

Dr. Shaghaegh Shahsavan
PhD in cell therapyو head of flow cytometry department

Marjan Asadi
Ms. Hematology, flow cytometry expert

Javad Geravand
Master molecular Genetics , molecular Genetics Expert

Mina Hajifathali
ReceptionIST

Bone Marrow Transplant Laboratory Tests

Learn More About Peyvand Laboratory Tests:

What is Flow cytometry?

Flow cytometry is a technology that rapidly analyzes single cells or particles as they pass single or multiple lasers while suspended in a salt-based buffer solution. Each particle is analyzed for visible light scattering and one or more fluorescence parameters.

Molecular genetics

Molecular genetics uses the laboratory tools of molecular biology to relate changes in the structure and sequence of human genes to functional changes in protein function and ultimately to health and disease. A new technology being developed for the $1,000 Genome Project promises to increase the breadth and scope of molecular genetics. Interpretations of clinical molecular genetics laboratory results are always rooted in the fundamentals of molecular and cellular biology and in the central paradigm that genes code for proteins. It is from these roots that modern and personalized medicine will grow.

HLA typing test

The human leukocyte antigen (HLA) system is a collection of major histocompatibility complex (MHC) proteins in humans. They are cell surface proteins that play an important role in the human immune system. Studies have shown that HLA is critical for disease defense, cancer protection, organ transplant rejection. Testing is usually only done in the context of a planned transplant, where you are the intended transplant recipient or potential donor. HLA TYPING TEST will identify the genes and (HLA) you have inherited, antibodies to the HLA antigens that cause the transplant to fail. Testing may also be done to identify HLA antigen types in platelet donors that are matched to transfusion recipients.

CALR Mutation Test

The CALR mutation test is used to help diagnose and classify bone marrow disorders that result in an overproduction of blood cells. These disorders are known as myeloproliferative neoplasms (MPN). Testing for genetic abnormalities associated with MPNs is usually done as a follow-up if a person has a marked increase in hemoglobin, hematocrit, red blood cell and/or platelet count, or blood smear findings suggestive of myelofibrosis.

Chimerism

From a medical point of view, the word chimera is used to define an individual in which there is a population of cells from genetically different individuals. This phenomenon can occur spontaneously, such as embryo-to-embryo transfer or embryo-to-mother transfer, or artificially in the case of allogeneic hematopoietic stem cell transplantation (HSCT).

JAK2

Janus kinase 2 (commonly called JAK2) is a non-receptor tyrosine kinase. The JAK2 gene provides instructions for making a protein that causes cells to grow and divide (multiply). This protein is part of a signaling pathway called the JAK/STAT pathway, which transmits chemical signals from the outside of the cell to the cell nucleus. The JAK2 protein promotes cell growth and division and is particularly important for controlling the production of blood cells from hematopoietic stem cells in the bone marrow.

PML-RAR, acute myeloid leukemia

PML-RAR is a unique subtype of acute myeloid leukemia (AML) called acute promyelocytic leukemia (APL). In this disease, promyelocytic cells (immature white blood cells) are overproduced and accumulate in the bone marrow. APL is caused by a genetic fusion between two genes, PML and RAR, forming a fusion gene called PML-RAR.

BCR-ABL test

BCR-ABL test is a genetic test used to diagnose certain blood cancers. In this test, the presence of the BCR-ABL gene sequence on chromosome 22 is examined, which helps diagnose this type of cancer.Additionally, this test is used to monitor treatment effectiveness and diagnose cancer recurrence

CEBPA gene

The CEBPA (CCAAT/enhancer-binding protein alpha) gene encodes a protein of the same name that is important for regulating the differentiation of blood cells.This protein is a transcription factor that binds to specific regions of DNA and helps control the activity of specific genes that play a role in the growth and development of certain blood cells. Additionally, this protein acts as a tumor suppressor, meaning that it is involved in cellular mechanisms that prevent irregular growth and division or an excess of cells.

FLT3 gene

FLT3 (fms-like tyrosine kinase 3) is a gene that provides instructions for making a protein called FLT3, which is a member of the receptor tyrosine kinase (RTKs) family of proteins. FLT3 is a cytokine receptor that belongs to the class III receptor tyrosine kinase and is expressed on the surface of many hematopoietic precursor cells.

Driver mutations ، جهش‌هایی هستند که در فعال‌سازی مسیرهای سیگنالی در سلول‌ها نقش اساسی دارند و باعث تغییرات بالینی در بیماری‌ها می‌شوند. بیماران نئوپلاسم‌های میلوپرولیفراتیو (MPN) دارای Driver mutations در ژن‌های JAK2، MPL یا CALR هستند که منجر به فعال‌سازی گیرنده ترومبوپوئیتین (TPOR) و مسیرهای سیگنالی پایین‌دست می‌شوند.

MPL gene

Driver mutations are mutations that play a fundamental role in activating signaling pathways in cells and lead to clinical changes in diseases. Patients with myeloproliferative neoplasms (MPN) have driver mutations in JAK2, MPL, or CALR genes, which activate the thrombopoietin receptor (TPOR) and downstream signaling pathways. JAK2 mutation is associated with permanent activation of TPOR, erythropoietin signaling (EPOR), and colony-stimulating factor 3 receptor (CSF3R).

Necessary Measures for Testing

Inform the laboratory technician about your diseases.

The performed tests at this laboratory do not require fasting.

During the sample collecting,
keep calm, and follow the given necessary instructions.