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Flow Cytometry for Hematolymphoid Neoplasm

Myeloma, Lymphoproliferative, Lymphoma, CLL, Leukemia, Myelodysplasia, Acute Leukemia, Hematolymphoid Neoplasm, Flow Cytometry, Hematolymphoid Neoplasm, Flow Cytometry for Hematolymphoid Neoplasm, (CSF), FHEMC 

Test Codes

EPIC: LAB6414, SOFT: FHEMG 

Department

Flow Cytometry

Specimen Collection Criteria

Collect: One of the following specimen types, as described below:

• Peripheral Blood: One Lavender-top EDTA tube or Green-top Sodium Heparin tube.
• Bone Marrow and Bone Marrow Core Biopsies: 2.0 mL bone marrow aspirate in a Lavender-top EDTA or Green-top Sodium Heparin tube. Bone marrow core biopsies in tissue culture medium (RPMI) or saline.
• Body Fluids: 5.0 mL body fluid in a Lavender-top EDTA or Green-top Sodium Heparin tube, or in a sterile collection container.
• Cerebrospinal fluid (CSF): 5.0 mL of CSF in a Lavender-top EDTA or Green-top Sodium Heparin tube, or in a sterile collection container. (Minimum: 0.5 mL). Deliver to the Laboratory immediately after collection.  Some specimen deterioration may occur over time.
• Tissue Biopsy/Fine Needle Aspirates (FNA): Tissue biopsies and FNAs should be placed in tissue culture medium (RPMI) and sent to the Laboratory via Surgical Pathology. Biopsies/FNAs must be refrigerated (2-8°C or 36-46°F) after collection. Some specimen deterioration will occur over time.

Do not put the specimen in formalin or any other fixative. A copy of the requisition and patient history must be sent with the specimen. 

Physician Office/Draw Specimen Preparation

Maintain blood and bone marrow at room temperature (20-26°C or 68-78.8°F) or body fluids, CSFs, solid tissues, FNAs and bone marrow core biopsies refrigerated (2-8°C or 36-46°F) prior to transport. Specimens must be received in the Laboratory within 48 hours of collection. 

Preparation for Courier Transport

Transport: Blood or bone marrow, at room temperature (20-26°C or 68-78.8°F), or body fluids, solid tissues, FNAs, and bone marrow core biopsies refrigerated (2-8°C or 36-46°F).

FedEx Shipping Instructions: Transport 4 mL whole blood or 2 mL bone marrow at room temperature. Transport 5 mL body fluid, CSF, solid tissue, fine needle aspirate (FNA) or bone marrow core biopsy refrigerated. Do not place specimen in formalin or any other fixative. Specimen must be received within 48 hours of collection.  

Rejection Criteria

Clotted tubes and specimens received greater than 48 hours post collection are acceptable with the approval of the Flow Cytometry Laboratory manager or pathologist on service. 

CSF specimens that do not meet one of the following criteria will be subject to cancellation: 

1. Atypical/suspicious lymphocytes or blasts detected be cytopathology or hematology review 
2. History of prior hematologic malignancy* 

NOTE: Flow cytometry analysis on these cancelled specimens may still be obtained with the approval of the Flow Cytometry Laboratory Medical Director or supervising Hematopathologist. 

*Studies have demonstrated that, in the absence of one of these two criteria, flow cytometry has a low yield for the detection of hematologic malignancy (reference – Am J Clin Pathol 2014;141:515).  

In-Lab Processing

Maintain blood and bone marrow at room temperature (20-26°C or 68-78.8°F) or body fluids, CSFs, solid tissues, FNAs and bone marrow core biopsies refrigerated (2-8°C or 36-46°F) prior to testing. The specimen should be analyzed within 48 hours of collection. 

Storage

Specimen Stability for Testing:

Blood and Bone Marrow
Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): Acceptable with the approval of the Flow Cytometry Laboratory manager or pathologist on service.
Frozen (-20°C/-4°F or below): Unacceptable

Body Fluids, CSFs, Solid Tissues, FNAs and Bone Marrow Core Biopsies
Room Temperature (20-26°C or 68-78.8°F): Acceptable with the approval of the Flow Cytometry Laboratory manager or pathologist on service.
Refrigerated (2-8°C or 36-46°F): 48 hours
Frozen (-20°C/-4°F or below): Unacceptable 

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days 

Laboratory

Royal Oak Flow Cytometry Laboratory

Performed

Monday – Saturday.
Results available in 1-2 days.

Reference Range

Pathologist's interpretation will state normal or abnormal antigenic expression. 

Test Methodology

Immunophenotyping by Multiparameter 10 Color Flow Cytometry. 

Interpretation

The antigen panel is determined by the clinical history and/or review of stained slides. The antigen expression is reviewed with available slides and provided clinical history to determine a differential diagnosis or final diagnosis. 

Clinical Utility

Testing is performed for lymphoproliferative disorders, leukemias, multiple myeloma, myelodysplastic syndrome, and myeloproliferative disorders. 

CPT Codes

88184, 88185x each additional marker (varies), 88187 – Interpretation 2-8 markers, 88188 - 9-15 markers, 88189 – 16 or greater markers. 

Contacts

Last Updated

8/9/2023