Use of a United States-based laboratory as a hematopathology reference center for a developing country: logistics and results

• Published in: International journal of laboratory hematology 2013-02, Vol.35 (1), p.77-81
• Main Authors: Deetz, C. O., Scott, M. G., Ladenson, J. H., Seyoum, M., Hassan, A., Kreisel, F. H., Nguyen, T. T., Frater, J. L.
• Format: Article
• Language: English
• Subjects: Aircraft; bone marrow; Bone Marrow - pathology; Bone Marrow Examination - economics; Bone Marrow Examination - standards; Developed Countries; Developing Countries; Eritrea; Health Care Costs; Hematologic Neoplasms - blood; Hematologic Neoplasms - diagnosis; Hematologic Neoplasms - pathology; Hematologic Tests - economics; Hematologic Tests - standards; Hematology - economics; Hematology - methods; Hematology - organization & administration; Humans; Infectious Disease Medicine - economics; Infectious Disease Medicine - methods; Infectious Disease Medicine - organization & administration; International Agencies; International Cooperation; Laboratory practice; Leishmaniasis - blood; Leishmaniasis - diagnosis; Leishmaniasis - parasitology; Leishmaniasis - pathology; Medical Oncology - economics; Medical Oncology - methods; Medical Oncology - organization & administration; Pathology, Clinical - economics; Pathology, Clinical - methods; Pathology, Clinical - organization & administration; Specimen Handling; Telecommunications; Time Factors; United States; Voluntary Health Agencies
• ISSN: 1751-5521; 1751-553X
• DOI: 10.1111/ijlh.12001

Summary Introduction With proper logistical support and sponsorship, a laboratory in an industrialized nation might be able to act as a reference laboratory for clinicians based in a developing country. Methods We built on previous experience in the clinical laboratory to see whether a specialized histopathology service (hematopathology) could be provided to a developing country without the expertise or experience to do it in country. Results Over an 13‐year period, 582 cases from 579 individuals were analyzed. Principal pathologic findings included acute leukemia in 84 cases (14%), dyspoiesis in one or more of the hematopoietic lineages in 65 cases (11%, including three cases with high‐grade myelodysplasia), 23 cases (4%) with findings suspicious for a chronic myeloproliferative disorder, 35 cases (6%) with findings suspicious for a lymphoproliferative disorder, and infectious organisms (presumably Leishmania in most instances) in 9 (1%) of cases. Specimens from 45 cases (8%) were unsatisfactory owing to extreme hemodilution and/or specimen degeneration. Conclusion With proper support, a medical laboratory in an industrialized nation may serve as a reference facility for a developing nation. The use of existing infrastructure may be remarkably effective to achieve optimal turnaround time. Although the lack of ancillary studies and follow‐up biopsies limit the ability to achieve a definitive diagnosis in many cases, this must be viewed in the context of the limited ability to diagnose or manage hematopoietic neoplasia in developing nations.