Hematologic Malignancy Genetics

Researchers continue to make rapid advances and discoveries related to genetics and blood cancer. Today, we are directly applying these insights to blood cancer prevention and treatment at the Hematologic Malignancy Genetics Clinic at Fred Hutchinson Cancer Center. 

At the Hematologic Malignancy Genetics Clinic at Fred Hutch — one of only a few clinics of its kind in the nation — our hematologist-oncologist, medical geneticist and genetic counselor are here to help patients understand their genetic risk and get them the follow-up treatment or surveillance (monitoring) they need. 

Hematologic Malignancy Genetics Clinic

At the Hematologic Malignancy Genetics Clinic at Fred Hutch, we help patients understand their risk of cancer using advanced DNA testing and genetic counseling. We also give recommendations for follow-up care to adult patients and family members who may be at higher risk of developing blood cancers (hematologic malignancies) or other non-cancerous disorders because of their family history.

Patients with existing blood cancer also benefit from testing, since knowing the results can lead to more effective, more precise treatments, which can mean better outcomes.

Learn more about the different ways our clinic can help you.

If You Are a Current Fred Hutch Patient

Talk with your Fred Hutch physician to find out if genetic testing might be right for you. If so, your physician can refer you to the Hematologic Malignancy Genetics Clinic at Fred Hutch.

If You Are Not a Current Fred Hutch Patient

Your physician can refer you to the Hematologic Malignancy Genetics Clinic at Fred Hutch for evaluation by calling (855) 557-0555. If you have a family history that you believe could put you at higher risk for a blood cancer, or if you already have a blood cancer and are interested in genetic testing, you can contact us directly to schedule a consultation.

“Being tested and finding out you may be at greater risk for developing a blood cancer matters. Many of our patients and their family members have received better, more precise care because their specific risk has been identified.”

— Sioban B. Keel, MD, Hematologist

What Happens at Your Visit

Before you visit us, we will review all of your relevant medical records, including your family medical history. At your first genetic consultation, you will meet with a genetic counselor, medical geneticist and hematologist-oncologist. This takes about one to two hours.

During your time with the genetic counselor, your counselor will go over your personal and family medical history with you. If there is a possible genetic risk, the counselor will talk with you about the option of genetic testing and the impact of your results.

Our medical geneticist works in partnership with the genetic counselor, helping to develop a plan for surveillance and screening, and continues to offer counseling on potential risks and impacts for your family.

During your time with our hematologist-oncologist, this physician will guide you on the impact of your existing hematologic disease, or your risk of developing a blood cancer, and what that means for treatment and surveillance.

If you decide to have genetic testing, depending on your unique situation and whether or not you have an existing blood cancer, you may have a blood draw, provide a saliva sample or have a skin biopsy. Genetic testing results usually take about a month.

After your results come back from the lab, you will meet with our genetic counselor to discuss your results and any treatment or follow-up care you may need. If your results show you have a genetic mutation (change), but you do not have an existing blood cancer, we’ll also discuss your personalized prevention plan and next steps, which may include follow-up care at the High Risk Surveillance Clinic or the Hematology Clinic at Fred Hutch.

Skin Biopsy

Sometimes we need to use a non-blood source of DNA for genetic testing, which means we will take a skin biopsy. This involves removing a small amount of your skin so it can be analyzed in a lab. Your skin will be numbed first, and a small stitch is often used to close the opening. If you need a skin biopsy, one of our team members will call you to schedule this procedure.

Your Care Team

Meet the caring, dedicated people who take care of you and your family at Fred Hutch.

Sioban B. Keel, MD

Sioban B. Keel, MD

Medical Oncology, Hematology

South Lake Union Clinic                       

Marshall S. Horwitz, MD, PhD

Marshall S. Horwitz, MD, PhD


South Lake Union Clinic                       

Genetic Counselor

Mercy Laurino, MS, CGC, PhD

Mercy Laurino, MS, CGC, PhD

Mercy Laurino is a certified genetic counselor. She manages Fred Hutch’s Breast and Ovarian Cancer Prevention Program, Gastrointestinal Cancer Prevention Program, Lung Cancer and Early Detection Program, as well as the Tobacco Cessation Counseling and the Genetic Counseling services. She is certified by the American Board of Genetic Counseling and licensed by the Washington State Department of Health. She is the recent recipient of the International Leader award from the National Society of Genetic Counselors.

What Each Team Member Does

The Hematologic Malignancy Genetics Clinic at Fred Hutch team is made up of experts from a variety of specialties within Fred Hutch. 


This physician specializes in blood cancers and oversees a blood cancer patient’s medicine-based treatments. At the Hematologic Malignancy Genetics Clinic at Fred Hutch, this provider recommends medicine-based treatments to match your specific genetic mutation. 

Medical Geneticist

A medical geneticist is a physician who is specially trained to know what types of genetic tests to order for patients, as well as how to interpret the results. Testing for genetic disorders is complex and includes many different types of tests. Interpreting the results also requires specialized knowledge, because results are typically not simple or straightforward. 

Genetic Counselor

This specially trained health care provider helps you understand your risk of a genetic disorder. A genetic counselor can also determine if genetic testing could be helpful for you, based on your personal and family medical and health history. After you have had genetic testing, a genetic counselor can offer information and resources for prevention; connect you with prevention programs, such as those available at Fred Hutch; and help with testing your family members, based on your results. Fred Hutch Genetic Counseling Service providers are all licensed, board-certified genetic counselors.

Registered Nurse (RN)

Your nurse manages your care alongside your physician. They also assist with procedures and treatments. They answer questions and help with a wide range of topics, like how to cope with side effects or get other services you need at Fred Hutch.

Patient Care Coordinator

The patient care coordinator will likely be one of the first people you meet when you come to Fred Hutch. They will gather your medical records and family health history and help guide you to the appropriate genetics or prevention care services within Fred Hutch. They work closely with you and your physician and serve as your scheduler.