Mayo Clinic Labs @Work
Thousands of people in hundreds of different roles work at Mayo Clinic Laboratories. Mayo Clinic Labs @Work offers a glimpse behind the scenes into this busy reference laboratory, featuring staff from throughout the organization talking about what they do and why they do it.
I’m a technical specialist in the Human Cell Therapy Lab. I joined the lab nine years ago, and I’ve been a specialist for the last seven. Although I’m a technical specialist, my work is geared toward development projects.
My role is pretty unusual within Mayo’s Department of Lab Medicine. Our lab is different from most other labs, as we have very few tests, and we’re very patient-focused. Rather than patient testing, the bulk of our work is blood product processing within Mayo’s Blood and Bone Marrow Transplant Program. So my work ends up being a bit different than the usual technical specialist.
It’s a little bit of everything, and each day is different. I usually start the day by making sure all our bench staff are scheduled appropriately to cover the workload. We have 10 bench techs, so in the scheme of the labs, we’re a small group.
After that, I jump right into whatever projects I have going on at that time. That ranges from researching different methodologies to designing experiments to performing validation runs. Once I complete a project, I then update our documents to implement it into our processes.
Along with my development work, at any moment I can get pulled aside to troubleshoot issues with equipment, tests, or processing. I’m fully bench-trained and well-versed in the standards and regulations our lab must follow, so I tend to get sidetracked quite a bit to support our lab’s operation. We’re also involved in clinical trials, either internally or partnering with external clients. I work with the trial personnel to review protocols, establish budgets, and create guidelines for our staff.
When patients need a transplant for some kind of hematologic malignancy —myeloma, lymphoma, or leukemia — we take the products, process them for the transplant, and then give them back to the patients.
In some cases, our standard methods won’t work, and there’s an urgent need to treat a patient with something unconventional. In those situations, I’m charged with researching and putting together an action plan. Then I ultimately lead the team that’s involved in carrying out the new process. Sometimes these are one-off procedures that we won’t do again. In other cases, we’ll turn it around and make it part of our standard practice, so we can treat more patients with the same condition.
For example, our lab tends to focus on CD34 cells — hematopoietic stem cells. They are the earliest stem cells in the bone marrow, and they delineate into white blood cells, red blood cells, and platelets. A standard transplant product contains less than 1% CD34 cells. In certain cases, those are the only cells the care team wants. We have a standard process to isolate them using magnetic antibodies, but this is typically done on fresh blood. Recently, the care team requested we perform this process on frozen cells in storage. Processing frozen cells creates a lot of challenges, as once you start thawing cells, they start to die, and the cell debris causes clumping and other issues with processing. I researched different methods to treat thawed cells and developed a revised process. After performing several mock runs, we were able to treat the patient, all within two weeks of being notified we had to do something new.
That’s one of the more extreme examples. Usually I get at least a few months to do these things. But it varies quite a bit, and that’s what keeps it interesting.
Since we’re not a typical lab, I’m not a typical technical specialist. When you think of a lab, most people think of high throughput, lots of machines, lots of tests. In our lab, we only do three tests, and our overall volume is a fraction of what other labs do. We are extremely patient-focused and only handle 10-12 patients per week. We get to follow a patient’s cells from the time they donate to the time we bring them to their hospital bedside and hand them to the nurse for infusion. Along with all the work we get to do in the lab, we have the unique opportunity to actually see those patients. We learn their names from working with the same products day after day. We sometimes meet them and their families. Getting thanked by them and hearing their stories adds so much extra value to our jobs.
A lot of the projects I get asked to do are so variable. They are often unrelated, so the knowledge I gain from working on one experiment doesn’t usually translate to the next one. Every time I start a new project, it’s starting from ground zero, and I have to quickly become our lab’s expert on it.
I’m always doing new and exciting things. When we are able to do a brand-new type of processing and then treat a patient who might otherwise go untreated — sometimes it’s even a life-or-death situation — and then they are able to go on and live well, all the stress and effort is definitely worth it.
As director of Regulatory Affairs for the Department of Laboratory Medicine and Pathology, Shannon Bennett helps safeguard Mayo Clinic’s reputation for quality care by ensuring that its clinical laboratories operate at the highest level of regulatory compliance.
As a clinical laboratory technologist, Daniel Kronemann enjoys going beyond his day-to-day work as he explores new ways to enhance processes and systems in Bacteriology.