Haematology Unit

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1. General Procedure For Submission Of Specimen

Most haematological tests are performed on blood specimens. Some tests, however, are performed on bone marrow aspirate. Type(s) of specimen(s) required for each test; the procedures for collection and preparation of each type of specimen are given in the following sections. Send all specimens immediately to the laboratory after collection.

A completed request form giving full particulars of the patients, the specimen and the required examination(s) must accompany every specimen. IT IS ESSENTIAL TO PROVIDE THE PATIENT’S IDENTITY CARD NUMBER. In the case of young children, the mother’s identity card number should be provided. Failure to do this may mean a delay in the despatch of results.

The clinician is advised to call the Haematology Unit of Cancer Research Centre for further information, appointment or consultation at telephone number: 03-40402375.

2. Collection And Preparation

2.1.Blood specimen

General:

Aseptically collect blood into the appropriate container. If a bottle/tube containing an anticoagulant is used, mix the contents thoroughly and carefully by gently inverting or rotating the bottle/tube. Seal the bottle/tube and send it to the Haematology laboratory immediately. If delay is unavoidable, blood specimens collected in bottles/tubes containing an anticoagulant should be stored in a refrigerator. The specimens should also be kept cool during transport by the use of ice packs or coolant.

For preparation of film/smear:

Collect venous blood into a bottle containing EDTA. With the aid of a tube or pipette, place a drop of blood on a clean glass slide. Using a spreader gently spread the blood. Allow the smear to dry in air. Label the slide, place it in a slide box and deliver it to the Division.

If fresh venous blood is not available, make spreads with blood collected by finger prick (or heel prick in the case of infants). As finger-prick blood is capillary blood, the differential, platelet, and white cell counts may differ from that obtained when venous blood is used; however, the red cell morphology is the same.

2.2. Bone marrow specimen

For culture:

For chromosomal studies of leukaemic cases, 1.0-2.0 ml of bone marrow aspirate is required. This should be collected in a sterile tube containing a tissue culture medium and heparin. The tubes are available on request from the Division.

SPECIMENS FOR HAEMATOLOGY

Examination	Specimen(S) Required	Container	Special Notes
Bone marrow aspirate examination	a) unfixed / fixed/ stained marrow films b)2 peripheral blood smears		Provide results of full blood picture (FBP, otherwise send for FBP.)
Chromosome analysis:*
a)Constitutional	3 ml blood	Sterile heparinised tube	Must be: a)collected under sterile conditions; b) packed in ice during transport. IMPORTANT: An appointment is necessary for the performance of this analysis.
b) Acquired (leukaemia and other disorders)	1.0-2.0 ml bone marrow aspirate	Sterile tube with heparin and 5 ml RPMI 1640 with5% foetal bovine serum	Must be: a)collected under sterile conditions; b) packed in ice during transport; c) accompanied by a fully completed “GENETICS” request form. IMPORTANT: The sample should reach the lab on any day in the morning except on the eve of any public holiday.
DNA analysis:
a) beta globin gene	5 ml blood	EDTA bottle
b) alpha globin gene	5 ml blood	EDTA bottle
Erythrocyte Sedimentation Rate (ESR)	2.5 ml blood	EDTA bottle	Specimens > 6 hr old will not be processed; this test should preferably be done in the peripheral laboratory.
Full Blood Picture	2.5 ml blood**	EDTA/heparinised bottle.	Specimens >8 hr old will not be processed.
Haemoglobin Analysis	a) 2.5-5 ml*** blood b) 2 unfixed peripheral blood smears	EDTA bottle	Specimen must be packed in ice during transport

* The indications for chromosomal studies are: a) congenital malformations; b) mental retardation (cause unknown); c) ambiguous genitalia; d) infertility (after exclusion of all other causes); e) multiple miscarriages or stillbirths; and f) leukaemia or myelodysplasia.

** In infants, smaller volume in the appropriate amount of EDTA may be submitted for counting using semi-automated machines which require a minimum of 0.2 ml blood.

*** In anaemic cases, more blood should be sent so that enough red cells are available for the preparation of haemolysate; e.g., for subjects with Hb <6 g/dl, 5 ml of blood should be sent.