Haematological Disorders

Types of referrals

The main reasons for referral are investigation of:

ALL
AML
MDS/MPD
CML
?Leukaemia

Sample Requirements

Bone Marrow

Bone marrow should be collected into a sterile universal bottle containing culture medium (including antibiotics) and heparin. Medium can be provided by the laboratory by request and should be stored refrigerated at 4°C. Medium should not be used beyond its stated expiry date; any unused, expired medium should be disposed of as clinical waste according to local policy.

A clotted sample is unsuitable for cytogenetic studies.
The sample should be sent as soon as possible directly to the department by a reliable transport system. A delay in the sample being processed may result in a failure to obtain dividing cells for full G-band analysis, or false negative results if there is preferential growth of normal cells in vitro.

Blood

It is acceptable to send a blood sample for the study of an acquired abnormality if there are sufficient circulating blast cells in the blood of the patient.

Blood should be taken in to a lithium heparin tube, and mixed well to prevent clotting

Adults - 2ml
Children - 2ml

More blood may be required if chromosome breakage studies are required.

Blood in EDTA will also be accepted, but success rates and quality may be compromised.

Blood in other containers is not suitable for culture. Clotted blood is unsuitable for chromosome analysis.

Sample Transport

Cytogenetic analysis requires living cells. Please ensure that the sample reaches us as quickly as possible (within 24 hours) First class post is satisfactory.

Samples should arrive within 24 hours of the aspirate being taken.

Where delays over 24 hours are unavoidable, e.g. aspirates taken on a Saturday or Sunday, samples should be refrigerated and sent to the laboratory to arrive on the next working day.

When sending samples by post a secure container should be used to conform to current postal regulations, i.e. P650 and UN3373 applicable. For more information please see here.

For the laboratory address and contact details, see the laboratory contacts page.

Reporting of Results

Results are sent to the referring clinician and entered onto the HMDS (HILIS) database.

Urgent priority is given to all new acute leukaemia and CML referrals with a reporting time of 14 days, according to the best practice guidelines.

Routine referrals should be reported within 21 days, according to the best practice guidelines

It is the policy of the laboratory to phone (or e-mail to nhs.net address) unusual or unexpected result to the referring clinician.

Complex or difficult to interpret abnormalities may require Fluorescent in situ Hybridisation to resolve the karyotype. This may delay some results.

The laboratory works in close collaboration with HMDS and some samples may be stored for one year after processing without analysis unless cytogenetics is specifically requested.