Alberta Precision Laboratories

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Organization:

Alberta Precision Laboratories

Test Name/Synonym:

Leukemia/Lymphoma Immunophenotyping, Non-Blood (Synonym: FACS, Flow Cytometry, LEUK/LOMA, MRD, XFACS)

Clinical Indications:

Flow based immunophenotypic testing represents an accurate and invaluable tool for the clinician and the pathologist in the diagnosis, subclassification, prognostication and follow up (MRD) of acute and chronic leukemias as well as non-Hodgkin lymphomas.

Clinical Indications may include:

Acute Leukemia
Lymphoma
Lymphoproliferative Disorder
Minimal Residual Disease
MRD - AML
MRD - B-ALL
MRD - T-ALL
Pancytopenia (bone marrow only)
Myelodysplastic Syndrome (MDS) (bone marrow only)
Plasma Cell Dyscrasia
Plasma Cell Neoplasm

Test Includes:

Immunophenotyping

Ordering Alert:

This information is for non-blood specimens only. For blood, see Leukemia/Lymphoma Immunophenotyping, Blood

Shipping and Handling Alert:

Specimens must be delivered within 24 hours of collection.

For testing sent to Edmonton: specimens must be delivered by 12:00 noon on the day before a weekend or a statutory holiday.

LABID (Connect Care):

LAB4328

Specimen Type:

Bone Marrow, Cerebrospinal Fluid (CSF), Core Biopsy, Excision, Fine Needle Aspirate (FNA), Lavage, Lymph Node, Other Body Fluid, Tissue, or Wash

Primary Container:

See Specimen Collection Requirements

Specimen Collection Requirements:

Hemolyzed or frozen specimens are not accepted. Clotted bone marrow specimens may be submitted for testing, however, it is a suboptimal specimen and results may be unreliable.

Do not place Flow Cytometry specimens into fixative solution.

Bone Marrow

Place 1 mL of bone marrow aspirate in 3 mL of Bone Marrow Media (BMM). The media may be kept frozen at -70°C until needed. Ensure the BMM is completely thawed before adding to specimen. BMM may be stored at 4°C for 1 week after thawing.
If BMM unavailable, sodium heparin or EDTA are also accepted.
In the event of a dry tap, a core biopsy may be submitted for testing. For specimens sent to Edmonton, core biopsy testing is only available with Hematopathologist-on-call approval.

Cerebrospinal Fluid (CSF)

Refer to: Cerebrospinal Fluid (CSF) Collection Guidelines (PX26-02.200)

Core Biopsy, Excision, Fine Needle Aspirate, Lymph Node, Tissue

Collect into Tissue Transport Medium (TTM).
See Client Resource – Lymphoma Protocol in Test Resources for more information.

Lavage and Other Body Fluids

Includes but not limited to: bronchoalveolar lavage (BAL) or abdomen, pleural, peritoneal, ascites, thoracentesis, pericardial, or vitreous fluids
Collect 2 to 20 mL in sterile tube. 5 mL is preferred to ensure adequate cells for testing.

Test Resources:

Flow Cytometry Requisition (22229)

Client Resource – Lymphoma Protocol

Cerebrospinal Fluid (CSF) Collection Guidelines (PX26-02.200)

To order Tissue Transport Media (TTM) or Bone Marrow Media (BMM):

For testing sent to Calgary: Request for Tissue and Bone Marrow Transport Media – Flow Cytometry
For testing sent to Edmonton: Ordering Supplies from Reagent Room

Stability and Storage:

Contact the laboratory for stability information if needed.

Processing:

Calgary Zone APL staff: follow site-specific and specimen-specific processes for specimen processing.

For bone marrow testing sent to Edmonton: send 1 unstained slide for each direct and particle bone marrow.

Transportation:

Specimen must be received at performing site within 24 hours of collection.

Transport at room temperature within 4 hours of collection. If delivery to the laboratory will exceed 4 hours, transport at refrigerated temperature.

For testing sent to Calgary from outside Alberta:

Transport by FedEx overnight shipping. Fax the tracking number and requisition to 403-270-4135.
Ship directly to:
Flow Cytometry
Arthur J.E Child Comprehensive Cancer Centre
3395 Hospital Drive N.W. Calgary, Alberta T2N 5G2
Tel: 587-231-3904 Fax: 587-231-3910
APLFlowCytometry@albertaprecisionlabs.ca

For testing sent to Edmonton from outside Alberta:

Ship directly to:
Specimen Control, Laboratory Medicine and Pathology
4th Floor Walter Mackenzie Centre (4B2.10)
University of Alberta Hospital
8440 112 Street NW, Edmonton, AB, Canada T6G 2B7
Tel: 780-407-4011 Fax: 780-407-8857

Testing Schedule:

Monday to Saturday

Reference Interval:

See laboratory report

Testing Area:

Flow Cytometry

Performing Site:

Calgary: Arthur Child Cancer Centre
Edmonton: University of Alberta Hospital

Additional Test Information:

Patient history or indication for testing is required.

For testing sent to Calgary:

Use Flow Cytometry requisition to avoid delays in specimen transport. Indicate clinical diagnosis on the requisition.
Alberta Testing Guidelines for Bone Marrow: Flow based testing is not recommended and will be cancelled for the following disease investigations:
- Neuroblastoma
- Classic Hodgkin staging bone marrow
- Diffuse large B cell lymphoma (DLBCL) staging bone marrows (PET scan recommended procedure)
- Anemia (single cytopenia)
- Thrombocytopenia (single cytopenia)
- Rule out Myelodysplastic syndrome (MDS) if CBC does not show cytopenia in more than 1 lineage
- Myeloproliferative neoplasms (MPN)
- Chronic eosinophilic leukemia
- Chronic Myelogenous leukemia (CML)
- Chronic neutrophil leukemia
- Essential thrombocythemia (ET)
- Mastocytosis
- Polycythemia vera (PCV)
- Primary Myelofibrosis (MF)

South Zone:

Specimen must be received in the laboratory by 10:00 (Medicine Hat) 11:00 (Lethbridge) to ensure same day delivery to Calgary.
For tissue specimens after hours, weekends, and statutory holidays: contact the laboratory to be forwarded to the pathologist on call.
- Lethbridge: 403-388-6057
- Medicine Hat: 403-502-8648 extension 1540

Contact Comments:

1-877-868-6848

Last Updated On:

Monday, March 17, 2025