Haematology and Blood Transfusion User Handbook

HAEMATOLOGY AND BLOOD TRANSFUSION USER HANDBOOK
Table of Contents Table of Contents...................................................................................................................................................................................................... 2 General Information .................................................................................................................................................................................................. 3

Location ...........................................................................................................................................................................................................................................3 Contact Numbers and Working Hours .............................................................................................................................................................................................3 Urgent Requests..............................................................................................................................................................................................................................4 Out-of-Hours Service (after hours Monday - Saturday, Sunday and Public Holidays). ..................................................................................................................4 Medical Staff ....................................................................................................................................................................................................................................5 Near Patient Testing facilities (Point of Care Laboratories).............................................................................................................................................................6 Phlebotomy Services .......................................................................................................................................................................................................................6 Vacutainer Guide .........................................................................................................................................................................................................................7 Completion of the request form .......................................................................................................................................................................................................8 Sample Collection (phlebotomy)......................................................................................................................................................................................................8 Sample Labelling .............................................................................................................................................................................................................................8 Sample Transport to the Laboratory ................................................................................................................................................................................................9 Special Handling Requirements ......................................................................................................................................................................................................9
Routine Haematology.............................................................................................................................................................................................. 10 Blood Transfusion ................................................................................................................................................................................................... 13 Routine Coagulation................................................................................................................................................................................................ 18 Haemostasis ........................................................................................................................................................................................................... 20 Special Haematology .............................................................................................................................................................................................. 25 Flow Cytometry (HIV and Malignancy Cell Markers)............................................................................................................................................... 29 Leukaemia Cytogenetics......................................................................................................................................................................................... 34
HAEM-PD-UserHbook V8 Authors: Karen Orfinada (Senior Biomedical Scientist) Sally McDonald (Senior Biomedical Scientist)
Haematology and Blood Transfusion User Handbook Authorised by: Dave Barnett
Page 2 of 38 Review Date: August 2015
General Information
Location The Haematology and Blood Transfusion laboratories are located at 60 Whitfield St London W1T 4EU. Samples are sent from the main hospital to Specimen Reception via the Pod system and sample deliveries made by courier or from other sites are made via a rear building entrance in Howland Mews. Near Patient Testing facilities for Haematology/Oncology patients are located on the Lower Ground Floor of the MacMillan Cancer Centre on Huntley Street. Contact Numbers and Working Hours Haematology General Manager Dave Barnett Training and Development Manager Stefan Kunka Quality Compliance Coordinator Susan Crouch Health & Safety Officer Norma McQueen Routine Haematology & Coagulation 9.00 19.15 Monday Friday 9.00 13.30 Saturday 9.00 13.00 Sunday 0203 447 8961 or 78961 0203 447 8961 or x78961 0203 447 8547 or x78547 Out-of-hours Bleep 7060 0203 447 8522/8523 or x78522/78523 Out-of-hours Bleep 7060 9.00 17.15 Monday - Friday 0203 447 8533 or x78533 9.00 17.15 Monday - Friday 0203 447 9887 or x79887 9.00 17.15 Monday - Friday
0203 44 78192 or x78192
9.00 17.15 Tuesday - Thursday
0203 447 9887 or x79887
9.00 17.15 Monday - Friday
Departmental Lead: Billy Janda Routine Haematology & General Enquiries Routine Coagulation Blood Transfusion Laboratory
9.00 19.15 Monday Friday 9.00 13.30 Saturday 9.00 13.00 Sunday 9.00 17.15 Monday - Friday 9.00 17.15 Monday Friday
Departmental Lead: Jenny Berryman Blood Transfusion Training and Compliance Officer: MAJOR HAEMORRHAGE
0203 447 8522/8523 or x78522/78523 Sangeeta Samuel 0203 447 8522/8523 or x78522/x78523
For a Major Haemorrhage at any time: dial telephone extension 2222 (or extension 32222 from the Heart Hospital) and state "Major Haemorrhage" to the switchboard operator to activate the UCLH Trusts Major Haemorrhage Protocol. In the event of a telephone network failure: dial the Analogue Direct Telephone Line to Blood Transfusion *020 7 631 0267, or Emergency Mobile *0771 851 2912. Note, these telephone numbers are for emergency use only: any use of these lines for routine communication will be reported as a clinical incident. Haemostasis Laboratory (Specialised Coagulation) Departmental Lead: Pamela Carr Special Haematology (Haemoglobinopathies) Departmental Lead: Norma McQueen Flow Cytometry (HIV and malignancy cell markers) 0203 447 9603 or 79603 9.00 17.15 Monday Friday 0203 447 8549/8529 or x78549/78529 0203 447 8545 or x78545 0203 447 8533 or x78533 9.00 17.15 Monday Friday 9.00 17.15 Monday Friday
Departmental Lead: Naina Chavda 0203 447 8541 or x78541 A limited Leukaemia Immunophenotyping service is available out-of-hours (subject to authorisation by a Haematology Consultant).
;
Leukaemia Cytogenetics
0203 447 9603 or 79603
9.00 17.15 Monday Friday
Samples are forwarded from the Flow Cytometry laboratory to external reference laboratories. Returned reports are scanned onto CDR. Urgent Requests Please contact the relevant laboratory during routine working hours, or Bleep 7060 outside routine working hours to alert laboratory staff to samples en route for urgent processing. Out-of-Hours Service (after hours Monday - Saturday, Sunday and Public Holidays). The Haematology Laboratory provides a 7 day / 24 hour restricted service outside of routine hours: a Biomedical Scientist can be contacted via the relevant Routine Haematology, Routine Coagulation or Blood Transfusion laboratory telephone extension number until 19.15 (see above), or via Bleep 7060 at any time. The following services are available out of routine working hours: Full Blood Count (FBC), Erythrocyte Sedimentation Rate (ESR), Blood Film Examination, Malaria antigen testing. Clotting Screen / Fibrinogen Assay / D-Dimers Group and Antibody Screen for Pre-op/Crossmatch Crossmatch Pre-op sickle testing Bleep 7060 to discuss any urgent requests for any services that are not usually available out of routine working hours.
Medical Staff Consultants Dr Marie Scully (Lead Clinician) Dr Kirit Ardeshna Dr Hannah Cohen (via secretary) Dr Bernard Davis Dr Shirley DSa Dr Victoria Grandage Dr Rajeev Gupta Dr Jonathan Lambert Dr Emma Morris Dr Ri Liesner Dr Karl Peggs Dr Martin Pule Dr Neil Rabin Dr Farrukh Shah Dr Kirsty Thomson Dr Sara Trompeter Dr Andres Virchis Professor Anthony Glodstone Professor Asim Khwaia Professor David C Linch Professor Stephen Mackinnon Professor John B Porter Prof Kwee L Yong Dr. John Paul Westwood Specialist Registrars 020 7025 7970 or 020 3447 9884 Email: nancy.moorcraft@uclh.nhs.uk 020 3447 9443 or ext 79443 Fax: 020 3447 9911 Email: melissacrozier@uclh.nhs.uk 020 3447 8563 or ext 78563 Email: christine.smith@uclh.nhs.uk 020 3447 9638 or ext 78538 Email: sarah.benn-hirsch@uclh.nhs.uk 020 3447 8028 or ext 78028 Fax: 020 3447 9911 Email: shirley.dsa@unclh.nhs.uk 020 3447 5239 or ext 75239 Fax: 020 3447 5827 020 3447 8483 or ext 78483 Email: anne.evans@uclh.nhs.uk 020 3447 9443 or ext 79443 Email: melissa.crozier@uclh.nhs.uk 020 3447 9712 or ext 79712 Fax: 020 3447 9571 Email: e.morris@medsch.ucl.ac.uk 020 3447 9884 or ext 79884 Email: nancy.moorcraft@uclh.nhs.uk 020 3447 9712 or ext 79712 Fax: 020 3447 9571 Email: k.peggs@ucl.ac.uk 020 3447 8483 or ext 78483 Email: anne.evans@uclh.nhs.uk 020 3447 8028 or ext 78028 Email: ysabel.howard@uclh.nhs.uk 020 3447 9638 or ext 79638 Email: sarah.benn-hirsh@uclh.nhs.uk 020 3447 9712 or ext 79712 Fax: 020 3447 9571 Email: suzie.knaptonuclh.nhs.uk 020 3447 9638 or ext 79638 Fax: 020 3447 9911 Email: sarah.benn-hirsch@uclh.nhs.uk 020 3447 9712 or ext 79712 Email: suzie.knapton@uclh.nhs.uk 020 3447 1528 or ext 71528 Email: Anthony.goldstone@uclh.nhs.uk 020 7679 6554 or ext 79456 Fax: 020 3447 9911 Email: joan.hammond@uclh.nhs.uk 020 3447 8483 or ext 78483 Fax: 020 3447 9911 Email: Melissa.crozier@uclh.nhs.uk 020 3447 9712 or ext 79884 Email: s.mackinnon@ucl.ac.uk 020 3447 9638 or ext 79638 Email: sarah.benn-hirsch@uclh.nhs.uk 020 3447 8028 or ext 78028 Fax: 020 3447 9911 Email: ysabel.howard@uclh.nhs.uk 0203 447 6854 or 020 3447 9884 or ext 79884 Email: nancy.moorcraft@uclh.nhs.uk (9.00 17.00 Monday Friday)
Haematology Laboratory SpR Bleep 7000 Blood Transfusion Laboratory SpR Bleep 7050 Haemostasis Laboratory SpR Bleep 7044 On-call Haematology Registrar/SpR (out-of-hours) Contact via Switchboard Clinical advice During routine working hours (Monday Friday 9.00 17.00), please contact the relevant laboratory Specialist Registrar via the bleep system. A Haematology Registrar/SpR is on call outside routine working hours: contact via the switchboard.
Near Patient Testing facilities (Point of Care Laboratories) Haematology Point of Care Laboratories provide Full Blood Count results exclusively for Haematology/Oncology outpatients receiving chemotherapy or attending clinic appointments. MacMillan Cancer Centre (Huntley Street), Lower Ground Floor 0203 447 6855 or extension 76855 8.00 17.00 Monday-Friday Phlebotomy Services Phlebotomy Manager: Nahid Weaver 0203 447 0168 or x70168 7.30 16.30 Monday Friday
Inpatient Services
University College Hospital Monday to Sunday 08:00 12:00 * Heart Hospital Monday to Sunday 08:00 12:00 * National Hospital for Neurology and Neurosurgery (NHNN) Inpatients Monday to Friday 08:00 12:00 * * Note: Outside of these hours, staff trained in phlebotomy must collect blood samples. Elizabeth Garrett Anderson wing (EGA) No inpatient service GP Service UCLH GP Blood Test Suite 2nd Floor, Mortimer Market Centre, Mortimer Market WC1E 6JB
Mortimer Market runs off Capper Street, which is a side street off Tottenham Court Road (across from Howland Street).
Outpatient Services
University College Hospital, 1st Floor Podium Monday, Tuesday, Thursday, Friday 08.30 16.30 Wednesday 08.30 19.00 Saturday, Sunday Closed Antenatal Clinic- UCH EGA wing (1st Floor) Monday, Wednesday, Thursday Tuesday Friday, Saturday, Sunday (*samples collected by ANC staff). Diabetic Clinic (UCH Podium, 1st Floor) Monday * 13:00 17:00 nd Clinics held every 2 Monday only
(appointments arranged by Diabetic Clinic staff).
Thursday 09:00 17:00 09:00 13:00 Closed *
08:30 17:00
Travel Clinic 2nd Floor, Mortimer Market Centre, Mortimer Market WC1E 6JB
Mortimer Market runs off Capper Street, which is a side street off Tottenham Court Road (across from Howland Street).
National Hospital for Neurology and Neurosurgery (NHNN) Outpatients Monday, Tuesday, Thursday, Friday 09:00 16:45 Wednesday 09:00 18:00 Saturday, Sunday Closed 5th Floor, Rosenheim Building Monday, Tuesday, Wednesday Thursday, Friday Saturday, Sunday 08:30 16:45 08:30 16:30 Closed
Monday Friday Appointment Wednesdays Fridays Saturday, Sunday
09:00 -16:30 13:00 -17:00 09:00 -13:00 Closed
Monday to Friday
07:30 - 16:30
Haematology and Blood Transfusion User Handbook Authorised by: Dave Barnett Page 6 of 38 Review Date: August 2015
Vacutainer Guide Becton Dickinson Vacutainer Ordering Information

EDTA 4.5 ml
Tests / Screens
FBC, ESR, Reticulocyte count, IPF, Blood film (note: ESRs cannot be performed on 7ml EDTA tubes), Sickle screen, Malaria Antigen testing Glandular Fever testing (note, Glandular Fever testing can be performed on an SST sample), Lymphocyte subsets (including CD4, CD8 counts), Hereditary Spherocytosis Dye binding assay, Plasma Viscosity, PCR in Haemostasis Blood Transfusion *Group & Save (including antibody screen), *Crossmatch, Kleihauer, DAT *Sample identification for Group & Screen or Crossmatch MUST be hand written with 4 correct points of ID.
Sodium citrate (citrated tube) 4.5 ml

Note : underfilled samples are unsuitable for testing.
Clotting screen / Fibrinogen / D-Dimers. These tubes must be filled exactly to the 4.5ml mark on the side of the tube: underfilled & overfilled samples are unsuitable for testing. For Paediatric Clotting Screens, see below. Citrated Platelet Count (alert Coagulation laboratory staff that the sample is en route: it must not be centrifuged). Specialised Haemostasis tests must be authorised by a Haematology/Haemostasis SpR/Consultant See the Haemostasis section below for the samples required for specialised Haemostasis tests. Cardiolipin antibodies (Antiphospholipid antibodies) 2GPI antibodies Haemoglobinopathy screen, G6PD assay, Pyruvate Kinase assay, Red Cell Osmotic Fragility, Globin Chain Biosynthesis, Oxygen Dissociation curve Cytogenetic chromosomal analysis and FISH.
SST 5ml Lithium Heparin 4.5 ml
Sodium citrate (citrate) 1.0 ml
Paediatric Clotting Screen, Fibrinogen, D-Dimers (1ml tubes). Contact the Haemostasis laboratory for other Haemostasis tests for paediatric patients. These tubes must be filled exactly to the 1ml mark on the side of the tube: underfilled & overfilled samples are unsuitable for testing. These tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and Phlebotomy Outpatient Departments and can be issued to other locations on request: contact x78549 or x78545. Monday Friday 09.00 17.15
Completion of the request form Please use the appropriate request form for the tests required and ballpoint (indelible) ink pen to complete the form. Please provide the patients full name, hospital number and date of birth. Please provide the date and time of sample collection and relevant clinical information to facilitate sample processing and the interpretation of results. Please use a separate Blood Transfusion request form for Blood Transfusion requests; Group & Save, Crossmatch, Kleihauer, DAT. Please ensure that the destination of the report, the name of the requesting/responsible clinician and a contact bleep/telephone number for the responsible clinician is provided to enable laboratory staff to notify the clinician regarding unsuitable (urgent) samples and to relay and/or discuss urgent or grossly abnormal results. Please tick the box next to the test(s) requested; if a required test is not listed, write it clearly into the Additional Tests section. Please tick the appropriate box when the patient is anticoagulated (on warfarin or heparin). If possible please provide clinical details.
Please ensure that adequate samples are taken for the tests requested and that each sample is labelled correctly. Contact the relevant laboratory for clarification of sample requirements if required. Sample Collection (phlebotomy) The sample collection policy for staff trained in phlebotomy [Haem-PD-BloodSampColl] and guidelines for sample labelling are available on the UCLH Intranet and can be sent electronically to GP practices. Sample Labelling Please label samples clearly with hospital number, first and last name and date of birth using a ballpoint (permanent/indelible) ink pen. The NHS number may be used in place of the hospital number for GP and non-UCLH Trust patients. Samples for a Group and Save (including an antibody screen) and Crossmatching must be hand written with four correct points of ID. Please include the time and date of collection and the signature of the person collecting the sample. A minimum of three points of identification must be provided for all other samples.
NOTE: Samples received broken/leaking, inadequately labelled, aged, clotted, haemolysed or otherwise unsuitable for testing will not be processed; an appropriate comment will be entered onto the computer system. If the requested tests are urgent, laboratory staff will attempt to notify the ward/clinician.
Sample Transport to the Laboratory UCLH samples: refer to the Pathology Specimen Transport and Pneumatic Tube System policies on the UCLH Intranet for hospital transport. Samples from GP practices must be sent via UCLH Trust transport; via the next available collection during the working day. If a significant delay in sample transportation to the laboratory is anticipated, please discuss with laboratory staff, as sample deterioration may limit the viability of results. Special Handling Requirements Please see the Notes section in the test tables below, or contact the relevant laboratory for information regarding special handling requirements.
Routine Haematology (page 1 of 3)

Autolab. 1st Floor, Whitfield St Laboratories, 60 Whitfield St London W1T 4EU Please contact the laboratory for reference range(s) if not listed below: Test Specimen Type Reference ranges Key Factors affecting tests Notes Out of hours service Time Limit for Turnaround time requesting from receipt of additional sample tests from time of venesection Within 24 12 hrs hours 0203 447 8961 or x78961 (Haematology) Bleep 7060 (out-of-hours) 0203 447 8547 or x78547 (Routine Coagulation)
Acanthocytes
4.5ml EDTA (can be performed on same sample as FBC) 4.5ml EDTA (can be performed on same sample as FBC)
0-3 %
Delay in receiving sample Sample not kept at room temperature
Send sample ASAP to the laboratory as prolonged storage affects cell morphology Send sample ASAP to the laboratory as prolonged storage affects cell morphology. Please give clinical details / reason for request
No service provided
Blood Film
Not applicable
Delay in receiving sample Sample not kept at room temperature
Service for clinically urgent requests
Within 24 hours
Urgent: 4hrs (not

out of hours unless the laboratory is contacted)
Nonurgent 24 hrs
Citrated Platelet Count (platelet clumping in EDTA)
4.5ml Sodium Citrate
150-400 x109/l
Clot in sample
ESR
4.5ml EDTA (can be performed on same sample as FBC)
<40yrs: 1-7 mm/hr (F) 1-5 mm/hr (M) 40yrs: 1-20mm/hr
Clot in sample Insufficient sample Delay in receiving sample
Please indicate clearly on the request form that sample is for a citrated platelet count. Notify the Routine Coagulation Laboratory that the sample is en-route: do not centrifuge the sample. Can be performed on same sample as FBC if sample >3mls. Cannot be performed on a 7ml EDTA tube.
Within 24 hours
8 hrs
Within 24 hours
Urgent 2 hrs
Nonurgent 24 hrs

Test Specimen Type Reference ranges Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Within 24 hours Sample must be received in the laboratory within 12 hours of collection Turnaround time from receipt of sample
Fluid Count (e.g. Pleural, Ascitic, Knee fluid) Full Blood Count (FBC)
Fluid to be taken into EDTA or 10 or 20ml sterile container 4.5ml EDTA
Delay in receiving sample Adult WBC:

3-10 x109l
Please use Urine/other request form-specify type of fluid > 1ml blood required Sample must be received within 12 hrs of collection Lipaemic/icteric samples can affect performance of test and may delay results
Clot in sample Insufficient, Lipaemic or Icteric samples Delayed sample receipt Clot in sample
Neutrophils:
2-7.5 x109/l
Haemoglobin:
11.5-15.5g/dl (F) 13-17 g/dl (M) MCV: 80-99 fl 150-400 x109/l
Service for clinically urgent requests Service for clinically urgent requests
4 hrs
Urgent: 1 hr
Nonurgent: 8 hrs
Platelets:
Glandular Fever Screen
4.5ml EDTA
Can be performed on FBC sample or a 4.5 / 7ml clotted sample
Test can be added on to existing FBC sample (time limit: 7 days)
No service provided
Within 7 days
Urgent: 2 hrs
Nonurgent: 24 hrs
Immature Platelet Fraction Malaria Antigen Test
4.5ml EDTA
Can be performed on FBC sample
Clot in sample Delayed sample receipt Clot in sample
Test can be added on to existing FBC sample All samples for malaria antigen tests are referred to Parasitology for confirmation -Please send requests for malaria parasite films and % parasitaemia directly to Parasitology laboratory
4.5ml EDTA
Can be performed on FBC sample)
8 hrs
Within 24 hours
Urgent: 1hr
Nonurgent: 8 hrs

Test Specimen Type Reference ranges Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Within 24 hours Turnaround time from receipt of sample
Reticulocytes
4.5ml EDTA
Can be performed on FBC sample
20-100 x 109/l
Clot in sample Delayed sample receipt Samples from children < 6 months old can give false negative results Anaemia Clot in sample
Test can be added on to existing FBC sample (time limit: 24 hours) All samples for sickle screens are referred to Special Haematology for confirmation (if not previously confirmed)
No service provided
8 hrs
Sickle Screen
4.5ml EDTA
(can be performed on same sample as FBC)
Within 7 days
Urgent: 1hr
Nonurgent: 24 hrs
Referral Laboratory (Malaria testing) Parasitology Laboratory Hospital for Tropical Diseases Building Capper St London WC1E 6JA 0845 155 5000 ext 75418
Blood Transfusion (page 1 of 5)

1st Floor, 60 Whitfield St London W1T 4EU 0203 447 8522 / 8523 or x78522 / 78523 (Routine hours) Bleep 7060 out-of-hours MAJOR HAEMORRHAGE (see page 4 of this user manual) Samples and form MUST carry full and correct patient identification, i.e. handwritten forename, surname, date of birth and hospital number - requests made without these details will not be accepted. Forms must be signed by both the requesting medical officer and the phlebotomist. The phlebotomist must sign and date the sample. Please provide a bleep number for enquiries. Please refer to the Trust Blood Component Transfusion Policy and Procedure available on the UCLH Intranet. Test Specimen Key Factors affecting Notes Out of Time Limit for Turnaround time from type tests hours requesting receipt of sample service additional tests from time of venesection Contact Contact laboratory to check whether Service for Crossmatch 4.5ml/7ml Incorrectly labelled, Urgent/STAT: 10 mins Laboratory clinically valid Group & Save available in EDTA Insufficient, clotted and plus transport time (only if urgent haemolysed samples will laboratory before sending sample. valid Group & Save requests be rejected. sample available in > 2ml required for adults laboratory). Otherwise 45mins for full >1ml required for neonates (<4 crossmatch or 10 mins months) uncrossmatched from receipt of sample in laboratory plus transport time. *If antibodies are present, turnaround time to be determined on a case by case basis. Non-urgent: same day non-emergency crossmatch: 2 hours plus transport time. *If antibodies are present, turnaround time to be determined on a case by case basis.

Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Within 5 days Turnaround time from receipt of sample
Direct Antiglobulin Test (DAT) Group & Save
4.5 /7ml EDTA
Can be added onto existing Group & Save or Haematology FBC sample
Service for clinically urgent requests Service for clinically urgent requests Service for clinically urgent requests No service provided
Urgent: 1 hr from receipt of sample in laboratory Non-urgent: 24hrs Urgent: 1 hr from receipt of sample in laboratory Non-urgent: 24hrs 24 hrs
4.5/7ml EDTA
Insufficient, clotted and haemolysed samples will be rejected. Delay in receiving sample. Sample not kept at room temperature before performing test.
>2ml required for adults >1ml required for neonates (<4 months) Sample should be ideally collected within 2 hours of delivery or sensitising event and MUST be tested within 24 hours (including Saturdays and Sundays) Referred to Red Cell Immunohaematology Department, North London Blood Transfusion Centre (NLBTC) Samples sent on Friday will not be collected by NLBTC until Monday Referred to Histocompatibility and Immunogenetics Department, NLBTC Samples sent on Friday will not be collected by NLBTC until Monday
Kleihauer
4.5ml EDTA
Sample must be received in the laboratory within 12 hours of collection Within 5 days
Antenatal: Anti D/c quantitation Anti-K titre
7-10ml EDTA + sample for Group & Save 7-10ml EDTA
Additional EDTA samples are required for test, contact the laboratory. Additional EDTA samples are required for test, contact the laboratory.
3 working days
HLA and disease association (e.g. HLAB27)
No service provided
5-7 working days

Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Additional EDTA samples are required for test, contact the laboratory. Turnaround time from receipt of sample
HLA typing
7-10ml EDTA (if white cell count <2 x109/l send double volume of blood)
Referred to Histocompatibility and Immunogenetics Department, NLBTC Samples sent on Friday will not be collected by NLBTC until Monday
No service provided
5-7 working days
Referral laboratories: Red Cell Immunohaematology North London Blood Transfusion Centre Charcot Road London NW9 5BG 0208 957 2831
Histocompatibility and Immunogenetics North London Blood Transfusion Centre Charcot Road London NW9 5BG 0208 957 2812
Requests for routine (scheduled) surgery Requests must be received in the laboratory by 1900hrs on the day before surgery Samples received after this time will be prioritised by order of the theatre list. Emergency cases will take priority. Requests for routine surgery should comply with the local Maximum Surgical Blood Ordering Schedule (MSBOS). Refer to the Trust Blood Transfusion Manual on the intranet.

Transport of Routine Blood and Blood Products Remote issue of red cells has been implemented at UCLH. This allows blood to be issued directly from the Remote Issue blood fridge at the point of care, rather than from the laboratory for most patients. A small percentage of patients will still need blood crossmatched by the laboratory but this can also be stored in the remote issue blood fridge and dispensed when required. FFP for patients will be sent to remote issue fridges by the laboratory and dispensed in the same way. Cross matched blood for patients with special requirements and those not eligible for remote issue and other blood products are dispatched as follows: Non-urgent blood and blood products are dispatched from the laboratory at various times during the day. Urgent blood and blood products are dispatched from the laboratory by courier (arranged by the laboratory). PLEASE CONTACT THE LABORATORY (x78523/78522 during routine work hours or Bleep 7060 out of hours) IF BLOOD IS REQUIRED URGENTLY. FFP will be returned to the laboratory 24 hours after it has been thawed. Unused platelets/FFP/Cryoprecipitate are withdrawn the day after the original date required Cryoprecipitate should be used within 4 hours of thawing and any remaining units returned to the lab.
*Always ring the laboratory before use of EMERGENCY UNCROSSMATCHED BLOOD*

Guidelines for Clinical Situations 1. Life threatening haemorrhage (acute massive blood loss) Massive obstetric haemorrhage Refer to the Major Haemorrhage Algorithm http://insight/departments/MedicineBoard/Pathology/HaematologyPathology/BloodTransfusion/Documents/Major%20haemorrhage%20algorithm.pdf For further Information refer to the Trust Major Haemorrhage Protocol http://insight/guidelines/Clinical%20guidelines/Major%20Haemorrhage%20Protocol%202012.pdf 2. Non-acute bleeding and neonatal surgery Obtain: Contact: Coagulation screen and FBC Blood Transfusion Registrar Monday Friday 09:00-17:00: UCLH Bleep 7050/7000 Discuss: All other times: General Haematology Registrar via UCLH switchboard
Appropriate treatment (If a high risk procedure, or the patient has a known coagulation abnormality, contact the Haemostasis Registrar prior to procedure and discuss the patients management) Monday Friday 09:00 17:00 All other times: Haemostasis Registrar UCH Bleep 7044/7000 General Haematology Registrar via UCH Switchboard
3. Indications for the transfusion of red cells, FFP, cryoprecipitate and platelets Please refer to the relevant chapter/appendix in the Trust Blood Component Transfusion Procedure Manual http://insight/guidelines/Clinical%20guidelines/Blood%20Transfusion%20Manual%202012.pdf 4. Patients with Special Transfusion Requirements For patients who may require CMV negative blood products, Irradiated blood products, Washed red cells and/or HLA matched platelets: Please refer to the relevant appendix in the Blood Component Transfusion Procedure Manual. Ensure that the laboratory has received a Blood Transfusion Status Form by emailing BT Status or by faxing to fax number 0203 447 9587 before requesting blood products (this form can be downloaded from the Blood Transfusion site on the UCLH intranet).
Routine Coagulation (page 1 of 2)

Autolab 1st Floor, Whitfield St Laboratories, 60 Whitfield St London W1T 4EU Tel: 0203 447 8547 or x 78547 Citrated samples must be adequately filled (a 9:1 blood:citrate sample ratio is required for all citrated samples). Tests cannot be performed on underfilled, overfilled, haemolysed or clotted samples. Paediatric citrated tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and Phlebotomy Outpatient departments and can be issued to other locations on request: contact x78549/78545 during routine hours. Include clinical details on the request form, e.g. patient receiving Warfarin/Heparin therapy or post op; to facilitate appropriate testing and interpretation of results. Send the request form and sample to the laboratory as rapidly as possible; notify the laboratory regarding very urgent requests on ext 78547 (during routine working hours) or Bleep 7060 (out of hours). Grossly lipaemic samples may require manual testing, potentially delaying results. Abnormal results that require further laboratory investigation and/or manual testing/confirmation may be delayed.
Test
Specimen type
Key Factors affecting tests
Note
Reference Range
Out of hours service
Coagulation screen PT/INR, APTT, TT, Fibrinogen
Heparin & Warfarin. Delayed receipt of sample. May not be possible on grossly lipaemic samples.
Heparin & warfarin therapy affects results and determines appropriate testing please indicate that the patient is on heparin and/or warfarin on the request form.
PT: 10-12 secs APTT: 25-37 secs TT: 15.5-18.5 secs Fib: 1.5 4.0 g/L
Time Limit Turnaround time for from receipt of requesting sample additional tests from time of venesection 5 hours Urgent: Non1hr urgent: 4 hrs
Routine Coagulation (page 2 of 2)

Test Specimen type Key Factors affecting tests Note Out of hours service Time Limit Turnaround time for from receipt of requesting sample additional tests from time of venesection 5 hours Urgent: Non1hr urgent: 4 hrs 5 hours Urgent: 1 hour Nonurgent: 4 hours
D-dimers
4.5ml Sodium Citrate 4.5ml Sodium Citrate Delayed receipt of sample.
This test can be added for an existing citrated sample. Please indicate Heparin therapy on the request form (tick box or handwrite). Please indicate Warfarin therapy on the request form (tick box or handwrite).
(Unfractionated) Heparin Monitoring: APTT ratio INR
Normal cut off: 0 0.55 mg/L FEU DVT/PE cut off: <550 g/L FEU Therapeutic range: 2.0 3.0
Delayed receipt of sample.
Overall range: 1.5 4.5 An individual patients target range is a clinical decision: contact the Anticoagulation Clinic (ext 75222/x79139, 9-5 Mon-Fri) for target ranges or seek advice from the Haemostasis SpR on bleep 7044 (during routine hours) or via the switchboard (outof-hours).
5 hours
Urgent: 1 hour
Non urgent: 4 hours
Haemostasis (page 1 of 6)
2nd Floor, 60 Whitfield St London W1T 4EU Hours: 09.00 17.15 Monday - Friday Tel: 0203 447 8545 / 8549, x78545 / 78549 All Haemostasis tests must be requested/authorised by the Haemostasis SpR (Bleep 7044), Haematology SpR (Bleep 7000) or Haematology Consultant, with the exception of the following: Cardiolipin Antibody testing; Plasma Viscosity measurement; Thrombophilia Screens from the Hyper Acute Stroke Unit (HASU) and the National Hospital for Neurology and Neurosurgery; Antiphospholipid Antibody Screens from Rheumatology Outpatients (Professor Isenbergs Clinic). Please discuss requests with Haemostasis laboratory staff if necessary, to ensure adequate samples are collected. Citrated samples must be adequately filled (a 9:1 blood:citrate sample ratio is required for all citrated samples). Tests cannot be performed on underfilled, overfilled, haemolysed or clotted citrated samples. Paediatric citrated tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and Phlebotomy Outpatient departments and can be issued to other locations on request: contact x78549/78545 during routine hours. Include clinical details on the request form to facilitate appropriate testing and interpretation of results. Send the request form and sample to the laboratory as rapidly as possible; plasma must be processed within 5 hours of venepuncture. For very urgent requests, notify the laboratory staff on ext 78549 / x78545 (during routine working hours) or Bleep 7060 (out of hours). . Test Specimen type Key Factors affecting tests Notes Reference Range Out of hours service Time Limit for requesting additional tests from time of venesection Contact the Laboratory Turnaround time from receipt of sample
Antiphospholipid Antibody Screen / Lupus Screen incorporates Lupus Anticoagulant testing and Cardiolipin Antibody testing
2 x 4.5 ml Sodium Citrate samples and 1 x 5ml SST sample
Warfarin, Heparin and Rivaroxaban therapy. Delayed receipt of sample (Lupus Anticoagulant test).
Lupus Anticoagulant testing is inappropriate when patients are receiving heparin therapy.
Contact the laboratory regarding Lupus Anticoagulant testing. Refer to Cardiolipin Antibody testing.
No out of hours service
3 working days
Test Specimen type Key Factors affecting tests Notes Reference Range Out of hours service Time Limit for requesting additional tests from time of venesection Contact the Laboratory Turnaround time from receipt of sample (in working days for non urgent requests) Urgent: 12 hrs Non-urgent: 5 working days
Anti-Xa assay For monitoring low molecular weight heparin LMWH) therapy. 2 Glycoprotein 1 Antibodies (B2GPI) Bleeding screen 1) von Willebrand Factor Antigen 2) von Willebrand Factor Activity 3) Factor VIII assays
1 x 4.5ml Sodium Citrated sample
Delayed receipt of sample
Samples should be collected 4 hours post an injection of Low Molecular Weight Heparin. A single SST sample is sufficient for ACLA & B2GPI Antibody testing.
Therapeutic range: 0.5 1.0 IU/ml. Individual patients target range is a clinical decision. IgG: < 10 U/ml IgM: < 6 U/ml
By agreement with the Haematology Consultant on call and subject to staff availability. No out of hours service
1 x 5ml SST sample
Contact the Laboratory
3 working day
7 x 4.5ml Sodium Citrated samples
Heparin affects FVIII result.
FVIII: 0.50 2.00 IU/ml VWFAg: 0.50 1.60 IU/ml VWFAct: 0.63 2.00 IU/ml
Recommendation: Delayed receipt also send an of sample. EDTA sample for a FBC.
Factor VIII only, by agreement with the Haematology Consultant on call and subject to staff availability.
3 working days
4) Platelet Aggregation
HAEM-PD-UserHbook V8 Authors: Karen Orfinada (Senior Biomedical Scientist) Sally McDonald (Senior Biomedical Scientist) Haematology and Blood Transfusion User Handbook Authorised by: Dave Barnett Page 21 of 38 Review Date: August 2015
Test
Specimen type
Notes
Reference Range
Time Limit for requesting additional tests from time of venesection
Turnaround time from receipt of sample (in working days for non urgent requests) 1 working day
Platelet Aggregation 7 x 4.5ml Sodium Citrated samples studies
Recommendation: also send an EDTA sample for a FBC)
Aspirin affects platelet aggregation: testing is not recommended while patient is on aspirin. Delayed receipt of sample. Samples not kept at room temperature. Significant thrombocytopaeni a: aggregation studies only possible with an adequate platelet count
Samples must be kept at Contact the room temperature and laboratory received by the lab within 1.5 hours of phlebotomy and before 1200 hrs.
Tests must be performed within 5 hours of venepuncture.
Test
Specimen type
Notes
Reference Range
Time Limit for requesting additional tests from time of venesection
Turnaround time from receipt of sample (in working days for non urgent requests) 1 working day
PFA-100 (Platelet function analysis)
1 x 4.5ml Sodium Citrated sample Recommendation: also send an EDTA sample for a FBC)
Aspirin affects results. Delayed receipt of sample. Sample not kept at room temperature. Significant thrombocytopenia, anaemia, leucopaenia.
The sample must be kept at room temperature & tested within 5 hours. Platelet Aggregation Studies must be requested separately if required.
Contact the laboratory
Cardiolipin Antibodies (ACLA)
1 x 5ml SST sample
This test does not require IgG: 12 authorisation. GPLU/ml IgM: 12 MPLU/ml Variations in temperature Delayed receipt of sample Samples must be kept at room temperature. Samples that have been refrigerated are unsuitable for testing. Samples should not be warmed, but warming does not make them unsuitable for testing 1.4 - 1.75 mPa
3 working days
Plasma viscosity
1 x 4.5ml EDTA sample
By agreement with the Haematology Consultant on call and subject to staff availability.
7 days
2 working days
Test
Specimen type
Notes
Reference Range
Time Limit for requesting additional tests from time of venesection Contact the Laboratory
Turnaround time from receipt of sample
Factor Assays FVIII, FIX, FXI, FXII FII, FV, FVII, FX FXIII
4.5ml Sodium Citrated samples contact the laboratory for the number of samples required (dependent on tests requested).
Heparin and Warfarin. Acute illness (contact the laboratory). Delayed receipt of sample Warfarin, Heparin and Rivaroxaban therapy. Delayed receipt of sample
Required factor assays must be specified on the request form.
Lupus Anticoagulant test Dilute Russells Viper Venom Time test or Taipan Venom Time test (on warfarin). Heparin induced
thrombocytopaenia
3 x 4.5ml Sodium Citrated samples
Lupus Anticoagulant testing is inappropriate when patients are receiving heparin therapy. An SST sample is required if Cardiolipin Antibody testing is also requested. This test MUST be authorised by a Haematology Consultant (i.e. not a SpR): contact via the Haematology SpR (bleep 7044/7000) or switchboard out of hours. Contact the laboratory
Factor VIII and Factor IX only: by agreement with the Haematology Consultant on call and subject to staff availability. No out of hours service
3 working days
3 working days
(HIT) screen Heparin:PF4 antibody assay
1 x 4.5ml Sodium Citrated sample (preferred)
Urgent test: send the sample to the lab. Immediately.
By agreement with the Haematology Consultant on call and subject to staff availability.
Urgent: 1 working day Non-urgent: 5 working days
Test Specimen type Key Factors affecting tests Notes Referenc e Range Out of hours service Time Limit for requesting additional tests from time of venesection Contact the Laboratory Turnaround time from receipt of sample (in working days for non urgent requests) 3 working days
Thrombophilia screen Antithrombin, Protein C, Protein S, Lupus Anticoagulant, Cardiolipin Antibodies, Factor V Leiden, Prothrombin Gene Mutation, MTHFR mutation. Also Factor VII and X assays when patients are on warfarin.
4 x 4.5ml Sodium Citrated samples + 1 x 5ml SST sample + 1 x 4.5ml EDTA
Delayed receipt of sample. Plasma must be processed within 5 hours of venesection. Warfarin and Heparin Acute illness may affect results of some tests
These tests require authorisation unless the patient is a Haematology, NHNN or HASU patient: for all other patients, please contact the Haemostasis or Haematology SpR (bleep 7044 or 7000) for authorisation before taking samples. These tests can be requested individually. Samples for Factor V Leiden, MTHFR and Prothrombin Gene Mutation are sent from Haemostasis, UCLH to TDL Genetics
Antithrombin, Protein C and Protein S only, by agreement with the Haematology Consultant on call and subject to staff availability.
Referral Laboratories:
Special Haematology (page 1 of 3) For Nucleotides, PF1.2 and TAT (Thrombin antithrombin complex) Haemostasis Research Unit, Department of Haematology University College London Hospitals 1st Floor, 51 Chenies Mews London WC1E 6HX
2nd Floor, 60 Whitfield St London W1T 4EU
For VWF Multimers Haemophilia Centre and Thrombosis Unit, Ground Floor Royal Free Hospital Pond Street London NW3 2QG
Hours: 09.00 -17.15 Monday Friday
For Factor V Leiden, Prothrombin Gene Mutation and MTHFR Mutation

TDL Genetics 3rd Floor 60 Whitfield Street London W1T 4EU 0203 447 8533 or x78533
Haemoglobinopathy & Haemolytic Anaemia investigations Reference ranges are provided on the report and on the IT system. Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Within 7 days Turnaround time from receipt of sample (in working days) Urgent: 2 hours if no further testing required Non urgent: 72 hours if no further testing required Urgent: 2 hours Non urgent: 24 48 hours Urgent: 2 4 hours Non urgent: 24 48 hours Urgent: 24 hours Non urgent: 24 48 hours
Haemoglobinopathy screen
4.5ml EDTA/Lithium Age of sample heparin + sample for FBC
Can be sample
performed
on
FBC No service currently
%Hb S levels
4.5ml EDTA/Lithium heparin
Can be sample
performed
on
FBC No service currently
Within 7 days
G6PD levels
4.5ml EDTA or Lithium heparin
Sample not stored at 2-6 C
Recent blood transfusion can No service invalidate the result. Please currently indicate if patient has been transfused recently. Recent blood transfusion can No service invalidate the result. Please currently indicate if patient has been transfused recently.
Within 7 days
Pyruvate Kinase levels
4.5ml Lithium heparin
Sample not stored at 2-6 C
Within 7 days
Special Haematology (page 2 of 3)

Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection 24 hours 48 hours Within 8 hours Turnaround time from receipt of sample (in working days) 24 48 hours 72 hours 72 hours
Haemoglobin H stain Heinz Body Preparation Hereditary Spherocytosis Dye Binding Assay Red Cell Osmotic Fragility Red Cell Oxygen Dissociation Globin Chain Biosynthesis
4.5ml EDTA or Lithium heparin 4.5ml EDTA or Lithium heparin 4.5ml EDTA
Age of sample Age of sample Age of sample
Samples greater than 48 hours old are unsuitable for this test. Samples greater than 48 hours old are unsuitable for this test. Please arrange with laboratory Samples greater than 24 hours old are unsuitable for this test.
No service provided No service provided No service provided
4.5ml Lithium heparin 4.5ml Lithium heparin 3 x 4.5ml Lithium heparin (10ml blood required)
Please arrange with laboratory Please arrange with laboratory Please arrange with laboratory
No service provided No service provided No service provided
Within 8 hours Within 8 hours Within 8 hours
72 hours 48 hours Urgent 5 working days Non urgent 10 working days
Haemoglobinopathy DNA and Haemochromatosis Erythropoietin
2 - 4 x 4.5ml EDTA (10 - 20ml blood required) 7ml clotted sample (no anticoagulant)
Referred to Haemoglobinopathy Genetics, UCLH Via Haematology consultant. Referred to Kings College Hospital
No service provided No service provided
Additional samples are required for test. Additional samples are required for test.
2-20 working days 10 -15 working days
Special Haematology (page 3 of 3)

Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Additional samples are required for test. Additional samples are required for test. Additional samples are required for test. Turnaround time from receipt of sample 4-8 weeks
Soluble Transferrin Receptor assay Transcobalamin
7ml clotted sample
Via Haematology Consultant. Referred to Kings College Hospital
No service provided
7 ml clotted sample
Referred to Royal Free Hospital. No service Sample must be separated within provided 2 hours. Referred to Royal Free Hospital Referred to Royal Free Hospital. No service provided
4-6 weeks
Liver Dry Iron Estimation
Biopsy sample in Formalin
2-6 weeks
Referral Laboratories:
Haemoglobinopathy Genetics 86-96 Chenies Mews London WC1E 6HY 08451 555 000 ext 5230
Department of Clinical Chemistry Kings College Hospital Denmark Hill London SE5 9RF 0207 737 4000 ext 3501
Special Haematology Royal Free Hospital Pond Street London NW3 2QG 0207 794 0500 ext 33413
For Paroxysmal Nocturnal Haemoglobinuria (PNH): Haematological Malignancy Diagnostic Service Level 3 Bexley Wing St James University Hospital Beckett Street LEEDS LS9 7TF
Flow Cytometry (HIV and Malignancy Cell Markers) (page 1 of 5)

2nd Floor, 60 Whitfield St, London W1T 4EU Hours: 09.00 17.15 Monday - Friday Tel: 0203 447 9603 or x 79603 Please see report or telephone laboratory for reference ranges Test Specimen Type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Within 24 hours Turnaround time from receipt of sample (in working days)
Acute Leukaemia screen. This includes Myeloperoxidase stain, Esterase stain and Tdt.
Bone Marrow in EDTA (can be performed on peripheral blood if bone marrow is not available) No minimum volume. Analysis can also be carried out on CSF, pleural and ascites fluid.
Sample not kept at room temperature Pleural, Ascites and CSF samples not being spun onto slides within 12 hours of being taken.
Please discuss with Haematology SpR (Bleep 7000/7001) before sending. Please send samples directly to Flow Cytometry laboratory. Please let flow cytometry laboratory know to expect sample. Transport samples at room temperature.
The service at weekends and Bank Holidays is for new acute leukaemia screens only and must be backed by Consultant Haematologist. Contact Laboratory on-call bleep 7060. Clinical staff must be available for interpretation of results as this will not be provided by laboratory staff.
Urgent: Results can be sent out within a 8 hours after being received in laboratory Non-urgent: 48hrs.
Chronic Leukaemia screen
Peripheral Blood in EDTA Can be performed on BM, CSF, pleural fluid and Ascites fluid. No minimum volume.
Sample not kept at room temperature
Please send samples directly to flow cytometry lab. Please let flow cytometry laboratory know to expect the samples. Transport samples at room temperature.
No service provided
Within 24 hours
Urgent: Results can be sent out within a few hours after being received in laboratory Non-urgent: 48hrs.
Flow Cytometry (HIV and Cell Markers) (page 2 of 5)

Test Specimen Type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Turnaround time from receipt of sample (in working days)
Lymphoma screen
Bone Marrow or Peripheral Blood (Can be performed on existing FBC sample) No minimum volume.
Please send samples directly to flow cytometry lab. Please let flow cytometry laboratory know to expect sample. Transport samples at room temperature.
No service provided
Within 24 hours
Urgent: Results can be sent out within a few hours after being received in laboratory Non-urgent: 48hrs.
Bone Marrow staining
8 x bone marrow smears
If BM in EDTA has been received instead of slides
The laboratory registrar / SHO should be contacted for bone marrow requests. Slides must be labelled in pencil with at least 3 points of patient id and the date of sampling.
BM received out of hours are not stained. If BM are urgent and need to be looked at out of hours, please bleep on-call laboratory staff to let them know to stain slides.
Within 24 hours
Urgent ( i.e. Acute Leukaemia): 1hr for staining + same day for reporting by Haem SpR/consultant Non-urgent: 24hrs for staining + further 4 working days for reporting by Haem consultant/ SpR

Test Specimen Type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Turnaround time from receipt of sample (in working days)
Lymphocyte subsets for HIV monitoring and for haematology patients.
1 x 4.5ml EDTA (Can be performed on existing FBC sample)
Clotted sample Sample not kept at room temperature
Please discuss all HIV negative requests with Haem SpR (Bleep 7000/7001) Samples should be <24hours old. Samples received after 1600hrs will not be processed till the next working day Transport at room temperature.
No service provided
Within 24 hours
24hrs
CD19 (for patients receiving anti-CD20 Rituximab)
4.5ml EDTA (Can be performed on existing FBC sample)
Clotted sample Sample not kept at room temperature
No service provided
Within 24 hours
24hrs
Paroxysmal Nocturnal Haematuria screen
No longer processed at UCH. All samples need to be sent to Leeds via Special Haematology
Not applicable
All samples are posted therefore should be <24 hours old. Please do not send samples on a Friday on the weekend as the samples will be too old for analysis.
No service provided
No service provided
No service provided

Test Specimen Type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Within 24 hours Turnaround time from receipt of sample (in working days)
Cerebrospinal Fluid (CSF) cytospin
CSF in 10/20ml sterile container No minimum volume
Please ensure samples arrive in laboratory no later than 1630hrs. (If white cells are seen upon microscopic examination of cytospin slides, they are referred to Haem SpR for verification)
All CSF requests received out of hours will be partially processed but not reported. If they need to be looked at out of hours the oncall lab staff need to be contacted. No service provided
24hrs (same day)
Iron stain
8 x Bone Marrow Slides
If BM in EDTA has been received instead of slides
Slides must be labelled in pencil with at least 3 points of patient id and the date of sampling.
Within 24 hours
Urgent ( i.e. Acute Leukaemia): 1hr for staining + same day for reporting by Haem SpR/consultant Non-urgent: 24hrs for staining + further 4 working days for reporting by Haem consultant/ SpR

Test Specimen Type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection Within 24 hours Turnaround time from receipt of sample (in working days)
Urinary Haemosiderin
10mls urine
None
Haemosiderin can persist in the urine for weeks following a haemolytic episode Please contact flow cytometry staff when sending.
No service provided
48 hrs + 2 working days for report by Haem SpR 24 hours.
Pleural or Ascites fluid
1ml fluid in sterile container
If sample is more than 24 hours
No service provided
Within 24 hours
Leukaemia Cytogenetics (page 1 of 5)

2nd Floor, 60 Whitfield St London W1T 4EU Hours: 09.00 17.00 Monday - Friday Tel: 0203 447 9603 or x 79603 All samples for Leukaemia Cytogenetics are sent from the Flow Cytometry Laboratory to referral Laboratories. Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection N/A Turnaround time from receipt of sample (in working days) Urgent referrals: 10 working days Routine requests: 15 working days
Cytogenetic (chromosomal analysis) -Testing for suspected haematological disease disorders (at presentation, post therapy or bone marrow transplant).
Aplastics/ general anaemia Acute Myeloid Leukaemia M1,M2,M3,M4,M4Eo,M5 A.L.L Burkitts Lymphoma CLL CML Diffuse Large B cell Lymphoma ET Follicular Lymphoma Mantle cell lymphoma MDS (CMML/RA/RARS/RAEB) Myelofibrosis Multiple Myeloma MPD (ET/Polycythaemia) NHL Pancytopenia Plasma cell Leukaemia PRV Thrombocytopenia/Neutropenia
Bone Marrow Peripheral Blood: 5-10ml Samples should be in Lithium Heparin or Cytopots (RPMI 1640 + Heparin medium). Except for CD138+ isolated plasma cells for FISH on multiple myeloma cases.
Poor sample quality (clotted or more than a day old) Sample transported and or stored above or below room temperature Sample Contaminated by bacteria Sample taken into wrong transport medium
Sent to: Great Ormond Street Hospital, Paediatric Malignancy Unit (PMU) Samples must be received before 2pm (Monday-Friday) for samples to get to PMU on the same day. Analysis will be carried as appropriate or in consultation with the referring Consultant or Registrar. The samples may be left overnight at room temperature and delivered to laboratory immediately the following morning.
No service provided

Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection N/A Turnaround time from receipt of sample (in working days) Rapid FISH: 3 working days Urgent referrals: 10 working days Routine requests: 15 working days
Cytogenetic FISH (Fluorescent Insitu Hybridisation) Analysis -Testing for suspected haematological disease disorders (at presentation, post therapy or bone marrow transplant).
Aplastic anaemia AML-M1,M2,M3,M4,M4Eo,M5 A.L.L Burkitts Lymphoma CLL CML Diffuse Large B cell Lymphoma ET Follicular Lymphoma Hypereosinophilic Syndrome Mantle cell lymphoma MDS Multiple Myeloma MPD (ET/Polycythaemia) NHL Plasma cell Leukaemia PRV
As above Bone Marrow or Peripheral Blood in EDTA for FISH only. CD138+ isolated plasma cells for FISH on multiple myeloma cases is preferable however bone marrow samples may also be adequate.
Poor sample quality (clotted or more than a day old) Sample transported and or stored above or below room temperature Sample Contaminated by bacteria Sample taken into wrong transport medium
Sent to: Great Ormond Street Hospital, Paediatric Malignancy Unit (PMU) Samples must be received before 2pm (Monday-Friday) for samples to get to PMU on the same day. Analysis will be carried as appropriate or in consultation with the referring Consultant or Registrar. The samples may be left overnight at room temperature and delivered to laboratory immediately the following morning.
No service provided

Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection N/A Turnaround time from receipt of sample (in working days) 10 working days
JAK-2 mutation analysis
Peripheral Blood/Bone Marrow in EDTA
Sent to: Great Ormond Street Hospital, Paediatric Malignancy Unit (PMU) Samples must be received before 2pm (Monday-Friday) for samples to get to PMU on the same day. Analysis will be carried as appropriate or in consultation with the referring Consultant or Registrar. The samples may be left overnight at room temperature and delivered to laboratory immediately the following morning. Sent to: Imperial College Molecular Pathology Laboratory Hammersmith Hospital Samples will be sent the following day if received after 2pm. Samples need to arrive before midday on Fridays and prior to bank holidays which span a weekend
No service provided
PCR BCR/ABL Ph+ve ALL
Peripheral Blood in 10-20ml EDTA
No service provided
N/A
10 working days

Test Specimen type Key Factors affecting tests Notes Out of hours service Time Limit for requesting additional tests from time of venesection N/A Turnaround time from receipt of sample (in working days) 10 working days
PDGFR receptor
Sent to Wessex Regional Genetics Laboratory, Salisbury District Hospital Samples will be sent the following day if received after 3pm. Samples need to arrive before midday on Fridays and prior to bank holidays which span a weekend Sent to: Department of Haematology, Royal Free Hospital Samples will be sent the following day if received after 2pm. Samples need to arrive before midday on Fridays and prior to bank holidays which span a weekend Sent to HMDS, St James University Hospital Samples will be sent the following day if received after 3pm. Samples need to arrive before midday on Fridays and prior to bank holidays which span a weekend
No service provided
Chimerism Studies T-cell receptor rearrangement
No service provided
N/A
10 working days
CLL
MRD IgVH
No service provided
N/A
10 working days

Referral laboratories: Paediatric Malignancy Unit Level 2 Camelia Botnar Laboratories Great Ormond Street Hospital Great Ormond Street London WC1N 3JH Haematological Malignancy Diagnostic Service (HMDS) St James Institute of Oncology Level 3 Bexley Wing St James University Hospital Breckett Street Leeds. LS9 7TF Imperial College Molecular Pathology Laboratory G-block 2nd floor, D2.04 Hammersmith Hospital Du Cane Road London W12 0HS Wessex Regional Genetics Laboratory Salisbury District Hospital Odstock Road Salisbury Wiltshire SP2 8BJ Department of Haematology Royal Free Hospital Pond Street Hampstead London NW32QG

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HAEMATOLOGY AND BLOOD TRANSFUSION USER HANDBOOK

Page 2 of 38 Review Date: August 2015

0203 44 78192 or x78192

9.00 17.15 Tuesday - Thursday

0203 447 9887 or x79887

9.00 17.15 Monday - Friday

Page 3 of 38 Review Date: August 2015

0203 447 9603 or 79603

9.00 17.15 Monday Friday

Page 4 of 38 Review Date: August 2015

Page 5 of 38 Review Date: August 2015

Thursday 09:00 17:00 09:00 13:00 Closed *

Monday Friday Appointment Wednesdays Fridays Saturday, Sunday

09:00 -16:30 13:00 -17:00 09:00 -13:00 Closed

Vacutainer Guide Becton Dickinson Vacutainer Ordering Information

Sodium citrate (citrated tube) 4.5 ml

SST 5ml Lithium Heparin 4.5 ml

Sodium citrate (citrate) 1.0 ml

Page 7 of 38 Review Date: August 2015

Page 8 of 38 Review Date: August 2015

Page 9 of 38 Review Date: August 2015

Routine Haematology (page 1 of 3)

Delay in receiving sample Sample not kept at room temperature

Delay in receiving sample Sample not kept at room temperature

Service for clinically urgent requests

Urgent: 4hrs (not

Citrated Platelet Count (platelet clumping in EDTA)

4.5ml Sodium Citrate

4.5ml EDTA (can be performed on same sample as FBC)

<40yrs: 1-7 mm/hr (F) 1-5 mm/hr (M) 40yrs: 1-20mm/hr

Clot in sample Insufficient sample Delay in receiving sample

Service for clinically urgent requests

Service for clinically urgent requests

Page 10 of 38 Review Date: August 2015

Routine Haematology (page 2 of 3)

Fluid to be taken into EDTA or 10 or 20ml sterile container 4.5ml EDTA

Delay in receiving sample Adult WBC:

Glandular Fever Screen

Test can be added on to existing FBC sample (time limit: 7 days)

Immature Platelet Fraction Malaria Antigen Test

Clot in sample Delayed sample receipt Clot in sample

Page 11 of 38 Review Date: August 2015

Routine Haematology (page 3 of 3)

Service for clinically urgent requests

Page 12 of 38 Review Date: August 2015

Blood Transfusion (page 1 of 5)

Page 13 of 38 Review Date: August 2015

Blood Transfusion (page 2 of 5)

Direct Antiglobulin Test (DAT) Group & Save

4.5 /7ml EDTA

Antenatal: Anti D/c quantitation Anti-K titre

7-10ml EDTA + sample for Group & Save 7-10ml EDTA

HLA and disease association (e.g. HLAB27)

5-7 working days

Page 14 of 38 Review Date: August 2015

Blood Transfusion (page 3 of 5)

5-7 working days

Page 15 of 38 Review Date: August 2015

Blood Transfusion (page 4 of 5)

*Always ring the laboratory before use of EMERGENCY UNCROSSMATCHED BLOOD*

Page 16 of 38 Review Date: August 2015

Blood Transfusion (page 5 of 5)

Page 17 of 38 Review Date: August 2015

Routine Coagulation (page 1 of 2)

Always ring the laboratory before use of EMERGENCY UNCROSSMATCHED BLOOD