King's has been a Regional Centre for diagnostic services for over 20 years, providing Immunophenotyping, Cytogenetic and Molecular Diagnostic services to haematologists; covering most of Southeast England, with populations varying from densely urban to rural. There is a wide variation in levels of affluence and deprivation.

Geography: Adult Population (16-85+) 5.5million

There has been a steady rise in referrals (now over 12,000 samples per year) to the King's laboratories, from clinicians who require increasingly sophisticated and accurate haematological diagnoses, for diagnosis and disease monitoring. The Flow Cytometry laboratory now processes over 3000 samples per year for Immunophenotyping. The Cytogenetics/FISH laboratory is one of the largest in the UK, with 10 cytogeneticists, analysing over 3000 samples/year by conventional cytogenetics and over 700 samples/year by FISH techniques.

Molecular Diagnostics already provide a wide repertoire of translocation detection, mutation screen analyses and quantitative monitoring for Minimal Residual Disease in myeloid and lymphoid diseases. Pre- and post-transplant molecular analysis with a 16 point genetic profile provides sensitive post-transplant Chimerism monitoring of engraftment to guide clinical intervention with DLI.

With the publication of the National Institute for Clinical Excellence (NICE) guidance on the cancer services, 'Improving Outcomes in Haematological Cancers' (IOG), King's has made the logical extension to develop the Regional Specialist Diagnostic Services as outlined in the guidance. This is also consistent with the Carter Report recommendations on NHS laboratory services in England (2) with regard to building capacity and providing an enhanced level of equipment and expertise.

King's has appointed a full-time IOG Consultant to develop these services and providing NICE IOG-compliant 'whole-system' integrated diagnostic and reporting processes capable of producing a final electronic integrated diagnostic report. This is achieved by developing a multidisciplinary team of specialist pathologists who provide a high-volume, rapid turn-round, integrated diagnostic service in a single laboratory.

The aims of the service are to provide:

  • Efficient, comprehensive diagnostic services for haematological malignancies.
  • Effective interface with Clinical Haemato-Oncology services
     through Multidisciplinary meetings (MDM).
  • Research, development, evaluation and introduction of new diagnostic techniques.
  • Rapid response to technology changes and clinical needs.
  • Support to clinical and epidemiological research.
  • Education and training programmes for clinical and scientific staff.