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Routine Laboratory Tests
All routine laboratory tests are available. Specimens include blood, urine, sputum and other body fluids.
Routine Body Scans
All routine body scans (including X-rays, ECGs, ultrasound scans, bone mineral density scans, CT scans, MRI scans, radioactive scans and PET scans) are available. These will be performed at the relevant medical imaging centers.
Special Blood Tests and Other Tests
These include blood clotting tests for bleeding or clotting blood disorders, tests platelet function abnormalities, vitamin deficiency tests, blood cancer tests, various genetic tests, immunity tests, blood transfusion compatibility tests, tissue typing for transplantation, and special tests for Multiple Myeloma. Other tests that are available include general health screening, 24 hour urine tests and skin biopsies.
Bone Marrow Examination
Examination of the bone marrow may be required in some patients to determine the health of the blood forming organs. There are 2 types of procedures – bone marrow aspiration (BMA) and bone marrow biopsy (BMB). In BMA, a small volume of the liquid part of the bone marrow is sucked out using a special needle and syringe; whereas in BMB, a tiny core of bone tissue is removed using a special needle. Both procedures are performed under sedation and anesthesia in the clinic.
Individualized Anti-Cancer Targeted Therapies
Previously cancer patients were treated with surgery, radiotherapy, chemotherapy and/or high-dose chemotherapy followed by stem cell rescue (transplantation). Today with the discovery of modern therapies, treatment is more precise or targeted, and accordingly treatment outcomes have improved. Moreover, not only has targeting of anti-cancer treatments improved and lowered the side effects associated with treatment, individualization of Targeted Therapy drug cocktails has greatly improved the suitability of such therapies at a personal level and result in prolonged cancer survival.
Outpatient Treatment
In many modern treatment regimens, drugs are given as an outpatient; i.e. without having to stay overnight in hospital. We have a separate Treatment Room where drugs for Targeted Therapies (see above), chemotherapy, antibiotic therapy, immunotherapy and other injections and infusions can be given under close supervision. The clinic is equipped with piped in oxygen, vacuum suction and emergency resuscitation equipment to enhance the safety of outpatient therapy.
Blood (Component) Transfusions
At appropriate times, some patients may require blood transfusions. The practice of blood transfusion today involves first separating donated whole blood into individual components – e.g. red blood cells, platelets and plasma – and then transfusing only the required blood component for that condition. Prior to transfusion the recipient’s blood group must first be matched with the appropriate donated blood component.
Venesection
Some patients with a certain blood disorders called Polycythemia have larger quantities of red blood cells than normal individuals. This causes the blood to become thick and flow more slowly. Such patients are in immediate danger and require rapid thinning of their blood. This can be done quite simply by removing blood just like in a blood donation. The procedure is called venesection and it can be life-saving.
Collection of Cell Separator Platelets (CSP)
Platelets are tiny cells that are found in the blood stream (peripheral blood). They are important in preventing and stopping bleeding. In certain conditions, e.g. dengue fever or chemotherapy, patients have very low platelet counts and require platelet transfusions. A machine called a cell separator can be used to collect platelets from the peripheral blood of a suitable platelet donor. The procedure is called apheresis. Following stringent safety checks and clearance by the Health Sciences Authority (HSA), CSP units can be transfused into patients who need them.
Peripheral Blood Stem Cell Harvesting (PBSCH)
Stem cells can be used to treat blood as well as degenerative disorders. Blood stem cells are mostly found in the bone marrow but also in the blood stream (peripheral blood). A machine called a cell separator is used to collect stem cells from the peripheral blood. The procedure is called apheresis. These stem cells are frozen and stored in liquid nitrogen for future treatment; i.e. stem cell therapy. Previously, it took about 2 weeks to collect sufficient stem cells for the treatment of blood cancers. We now have a new PBSCH program that halves the collection time to about 1 week or less.
Therapeutic Plasma Exchange (TPE)
Plasma is the liquid portion of blood. The other portion of blood is made up of cells (mainly red blood cells, white blood cells and platelets). In certain conditions, e.g. Multiple Myeloma or Myasthenia Gravis, patients have large quantities of very abnormal proteins in the plasma. Such patients are in immediate danger and require rapid removal of these abnormal plasma proteins. A machine called a cell separator can be used to specifically remove abnormal plasma from the peripheral blood and replace these with suitable (clean) plasma products. The abnormal plasma that has been removed is discarded. The procedure is called apheresis and it is frequently life-saving.
Therapeutic Leucocyte and/or Platelet Removal (TLR and/or TPR)
In certain blood disorders, e.g. Myeloproliferative Disorders or Leukemia, patients have large quantities of white blood cells and/or platelets. Such patients are in immediate danger and require rapid removal of these abnormal white blood cells and/or platelets. A machine called a cell separator can be used to rapidly remove large quantities of abnormal white blood cells and/or platelets from the peripheral blood. The abnormal plasma that has been removed is discarded. The procedure is called apheresis and it is frequently life-saving.
Stem Cell Transplantation
There are 2 broad categories of stem cell transplantation – autologous (to oneself) or allogenic (from a donor to a patient). Both types of hematological stem cell transplantation (HSCT) can be performed on appropriate patients. This program is a very specialized one. Prior to transplantation, suitability of patients to undergo transplantation as well as collection, processing and storage hematological stem cells must first be performed.