Alberta Precision Laboratories

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Organization:

Alberta Precision Laboratories

Message Alert:

PLEASE NOTE: This Test Directory is in an interim state and due to changes pertaining to the DynaLIFE transition, performing site for routing has not been updated. Please refer to Laboratory Information System for appropriate routing.

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)

10 mL of CSF in sterile tube is preferred, minimum 2 mL.
Calgary Zone, Central Zone: see CSF Collection Guidelines in Test Resources for more information.
Edmonton Zone: See Provincial Connect Care CSF Collection Guidelines in Test Resources for more information.

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:

For testing sent to Calgary:		For testing sent to Edmonton:
	Flow Cytometry - FC3200 (Calgary) Flow Cytometry Out of Province Requisition - FC3200EP (Calgary)		Hematology Specialty Requisition RPASPF00002UAH Referred In Specimen Tracking Form

Client Resource – Lymphoma Protocol

Calgary Zone: CSF Collection Guidelines

Central Zone: Spinal Fluid Collection Protocol

Edmonton Zone: Provincial Connect Care Cerebrospinal Fluid Collection Guidelines

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 specimens sent to Calgary:

Specimens from within Calgary Zone:
- APL staff: follow site-specific and specimen-specific processes for specimen transportation
Specimens from outside Calgary Zone:
- Transport by FedEx overnight shipping. Fax the tracking number and requisition to 403-270-4135.
- Ship directly to:
  Flow Cytometry Laboratory
  7th Floor McCaig Tower, Foothills Medical Centre
  1403 - 29 Street NW, Calgary, AB, Canada T2N 2T9

For testing sent to Edmonton from outside Alberta:

Complete Referred In Specimen Tracking Form, provide expected arrival date and time, check priority “Time Sensitive”, and fax to 780-407-6267.
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

Testing Schedule:

Monday to Saturday

Reference Interval:

See laboratory report

Testing Area:

Flow Cytometry

Performing Site:

Calgary: Foothills Medical 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 requisitions 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:

Thursday, January 11, 2024