Laboratory Investigation of Haematological Malignancies
The investigation of haematological malignancies requires an integrated diagnostic approach, incorporating a variety of laboratory techniques (see below). Some investigations are performed ‘in-house’ while others are sent to specialist referral laboratories. The results of all investigations are combined into an integrated diagnostic report which is reviewed by a Consultant Haematologist. A diagnostic opinion is given based upon the current WHO classification of haematological malignancies.
Diagnostic Techniques
| Technique | Details |
| Morphology |
Peripheral blood and/or bone marrow aspirate spread onto glass slides for review by conventional light microscopy.
Useful for the investigation of chronic lymphoproliferative disorders and acute leukaemias. |
| Flow Cytometry (Immunophenotyping) |
Characterisation of antigen expression of cells in suspension, usually peripheral blood and/or bone marrow aspirate, using a panel of antibodies labelled with fluorochromes.
Useful for the investigation of chronic lymphoproliferative disorders and acute leukaemias. |
| Histopathology |
Assessment of fixed tissue prepared as tissue sections. Useful for the examination of lymph nodes and bone marrow trephines.
Useful for the diagnosis and classification of lymphoma. |
| Cytogenetics/FISH | Genetic techniques that examine cells for changes that provide prognostic information for lymphoid and myeloid disorders. |
| Molecular Genetics | Molecular techniques to identify mutations or molecular markers for diagnosis, prognostication and response to therapy for chronic lymphoproliferative disorders and acute leukaemias. |
Specimens & Testing Laboratory
| Diagnostic Technique | Testing Laboratory | |
| Morphology |
Peripheral blood in EDTA. Bone marrow aspirate spread onto glass slides.
|
RDE Haematology Laboratory
|
| Flow Cytometry (Immunophenotyping) | Peripheral blood or bone marrow aspirate in EDTA |
Bristol Haemato-Oncology Diagnostic Service Southmead Hospital |
| Histopathology | Formalin fixed tissue |
RDE Histopathology Laboratory
|
| Cytogenetics/FISH | Peripheral blood or bone marrow aspirate in lithium heparin |
Bristol Haemato-Oncology Diagnostic Service Southmead Hospital |
| Molecular Genetics | Peripheral blood or bone marrow aspirate in EDTA |
Bristol Haemato-Oncology Diagnostic Service Southmead Hospital
OR
Molecular Oncology Diagnostic Unit Guy’s Hospital |
Special Instructions
Specimens should be delivered straight to the hatch at the Blood Sciences main reception (A2) with an accompanying Bone Marrow request form and/or Bristol Haemato-Oncology Diagnostic (BHODS) request form . Samples need to be received in the lab by 3 o’clock in order to meet the postal deadline for next day delivery. Samples should be handed directly to the Senior Haematology BMS or Duty Biochemist, indicating urgency where possible. Samples will be posted to referral labs with guaranteed next day delivery.
Urgent Requests
Please inform BMS staff in the Haematology Lab (X2916) if you require your specimens to be processed urgently. They will organise same-day transportation of specimens to the referral laboratories.
Factors Affecting Results
Samples with poor integrity (clotted, aged, haemolysed, underfilled) may not be suitable for testing.
Turnaround Times
Turnaround times are variable depending on testing required.
For urgent requests, it may be possible to have some results within 24 hours. Please liaise directly with the Haematology Laboratory (X2916) or on call Haematology Consultant.
Clinical Advice
Clinical advice is available from the Haematology Medical team.
Phone: Call RDE switchboard 01392 411611 & ask for on-call Haematology Consultant
E-mail: rde-tr.HaematologyDepartment@nhs.net
The lead RDE clinician for the Haemato-Oncology diagnostic service is: Dr Jason Coppell, Consultant Haematologist
Specimen Labelling Procedure
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