About Us

Diagnostic hematology, or so called laboratory hematology is a study of diagnostic test for hematologic disorders, which is an essential field of hematology. Accordingly, a laboratory physician more specifically a laboratory hematologist plays a fundamental role in communicating with clinical physicians for properly treating patients with the laboratory results from hematology analyzers and microscopic examinations.

Due to the rapid advancements in medicine, the vast amounts of knowledge and diagnostic methods have been continuously updated in Korea. Taking a look back at the history of diagnostic hematology from the 1980s, the role has changed from clinical pathologist to a laboratory physician, working in diagnostic hematology and other laboratory and diagnostic fields of subspecialties. The establishment of the idea for laboratory subspecialties and the current laboratory affairs has a rather short history of 20 years in its development.

Advancement of diagnostic hematology in laboratory medicine

From the most practical textbook by Bauer in the mid 1980s, hematology section possesses the foremost part, introducing Coulter Model S and Ssr as the generally used hematology analyzers. Whereas these instruments were only able to provide seven hematologic results without a platelet count, the succeeding Coulter Model S880 could analyze platelet count within the same equipment, and the concept of CBC was reestablished. Many different types of automated hematology analyzers available world-wide, Sysmex XE-2100, Bayer ADVIA 2120, and Beckman Coulter LH750 are the most utilized equipments in large medical centers of Korea, also to mention the recently released Abbott Cell-Dyn Sapphire and Pentra 120 by Horriba ABX. The latest equipments are able to measure all parameters of blood cells including reticulocytes, with the option of automated slide making and staining.

While Bauer’s clinical laboratory methods was the main textbook until the early 1980s and went out of print, ‘Henry’s clinical diagnosis and management by laboratory methods’, which has the long history for a century, replaced its place. From its 1996 version, a new chapter of molecular pathology was introduced, including molecular diagnostic methods for hereditary diseases, hematologic malignancy and infectious diseases. As molecular diagnosis is being utilized in all fields of diagnostics, the recent revised version published in every 5 years, emphasizes the rather overlooked importance of molecular cytogenetics, especially of its role in the hematologic disorders. Diagnostic hematology usually includes CBC, bone marrow examination, flow cytometric analysis for the leukemia markers, anti-platelet antibody, and routine or special coagulation tests. The recent ‘Henry’s clinical diagnosis and management by laboratory methods’ include tests of transfusion medicine in the field of diagnostic hematology and has a separate chapter on the rapidly advancing field of hemostasis and thrombosis related analysis. In the future, cytogenetic and molecular genetic tests utilized in hematologic malignancies are anticipated to be included in the hematology section due to its nature.

Five year survival rate of leukemia has improved to 50~80% from the ceaseless efforts in development of therapeutic agents, however, the importance of advancements in diagnostic methods should not be ignored. Since the introduction of FAB classification for acute leukemia in 1976, constant modifications and supplements were made. Twenty years ago, morphologic approaches of leukemic cells and its cytochemical aspect were the basis of the diagnosis for leukemias. As immunophenotype analysis improved, a more clinically relevant immunologic classification of ALL was introduced in late 1980s and advancements in cytogenetics and molecular genetics were able to establish the WHO classification which gained its consent from the new millenium.

While several university hospitals have examined for the Philadelphia chromosome in CML patients from late 1970s, it was until 1990 when cytogenetic analysis for hematologic malignancies was clinically utilized in general. This can be explained by the fact that cancer cytogenetics requires extensive knowledge and skills of chromosome analysis for its precise results. The automated karyotype analyzer for chromosome analysis and FISH being introduced in early 1990s was a stimulus for chromosome analysis to be accepted in general among university hospitals. Molecular genetics in clinical fields of diagnosis is currently being lead by laboratory medicine specialists. Marked progress in quality assurance was made as diagnostic molecular genetics division was added to the Korean Association of Quality Assurance for Clinical laboratory, founded in 1977.

Activities in Korean hematology-related societies

Many contributions to the 50 year long Korean Society of Hematology (KSH), Korean Society of Blood Transfusion (KSBT) founded 1982, 10 year long Korean Society of Blood and Marrow Transplantation, Korean Society of Pediatric Hematology-Oncology and the Korean Society on Thrombosis and Hemostasis has been made by laboratory medicine specialists from the beginning, and further consistent contribution of diagnostic hematologists is being anticipated.

The Korean Society for Laboratory Hematology (KSLH), starting in 2001, includes not only laboratory medicine specialists but also the staffs of hematologic laboratories of each hospitals, and acts as a catalyst for the advancement of diagnostic hematology. Five scientific symposiums were held in winter, appealing to members by dealing with frequently colliding matters in clinical hematologic laboratories. By its starting year in 2002, case oriented workshops on various morphology of peripheral blood lymphocytes, relationship of red blood cell morphology and diseases, and difficulties in leukocyte differential counts were held, also to include the subject of morphology of various body fluids. In 2003, quality assurance of the most utilized automated hematology analyzers, Sysmex XE-2100, Bayer ADVIA 120, Beckman-Coulter LH 750 and Abbott Celldyne 4000 and their respective merits were discussed. NCCLS guidelines for coagulation tests, quality assurance and experience of using Sysmex CA7000 and Stago STA were also included.

In 2004, automated leukocyte differential count, reticulocyte count, ESR autoanalyzer, cell count of CSF using automated hematology analyzer and peripheral blood smear production were the topics. Discussions on the WHO classification of hematologic malignancies were also made. Coagulation test were the main issue in 2005 in which comparision of major PT and APTT reagents used domestically was of much concern among attendees. Newly introduced automated hematology analyzers and comprehensive review of molecular diagnostic methods of hematologic malignancies was done in 2006. It was also a time for an enthusiastic discussion on the immunophenotypic analysis of hematologic malignancies through panels.

For the globalization of the diagnostic hematology, many members are actively participating in scientific symposiums including the International Society for Laboratory Hematology (ISLH) and the American Society of Hematology (ASH) [August, 2009].