Leukemia Immunophenotyping
Lymphoma Immunophenotyping
Flow Cytometry, Tissue
Flow Cytometry, Fluid
Flow Cytometry, Bone Marrow
Flow Cytometry, Blood
Flow Cytometry, Lymphoproliferative Disorder
Tissue Panel, Leukemia Immunophenotyping

Based on the clinical information provided by the client and a morphologic evaluation of the specimen, a Veripath hematopathologist will determine the specific immunophenotyping panel to be performed.  This panel is a carefully considered combination of antibodies, which allows for accurate assessment of specific cell populations within a specimen (for example, a lymph node specimen is assessed with a panel predominantly focusing on T-cells and B-cells, whereas a bone marrow evaluation also includes markers for granulocyte/monocyte populations, depending on the clinical context).  This approach allows the identification of abnormal populations that may not be suspected at the time of specimen submission.  An interpretation of the immunophenotypic findings and correlation with the morphological features is provided by a Veripath hematopathologist.

Special Instructions for ALL specimens for Immunophenotyping for Leukemia and Lymphoma

• SPECIMEN CANNOT BE FROZEN or placed in any fixative (i.e. Formalin)
• To process the specimen, the request form MUST include:
  • Collection date
  • Pertinent clinical history (with relevant ICD-9 codes, if available)
  • Specimen source (fluid type, tissue origin)
  • Patient identification (i.e. name, DOB, MR #)
  • Physician Requesting Test

Bone Marrow:

• At least 3 mL of bone marrow is preferred (or as much as possible, depending on situation).  BM collected in a heparinized syringe should be sent to the laboratory immediately or inoculated into ACD (Solution A or B), EDTA, or Na Heparin tube. 

All tubes must be properly drawn; partial draw may cause cell lysis and loss due to hypertonic osmotic changes.

Transport Instructions:

• Room temperature (20-25°C) with immediate delivery to the laboratory
• For overnight storage, bone marrow samples should be inoculated into 20% NCS (RPMI preparation provided by lab) and refrigerated (2-8°C). 

Peripheral Blood:

• One full 10 mL yellow top tube (ACD Solution A or B) is preferred, or
• One full 5 mL green top tube (Na Heparin) is acceptable, or
• One full 5 mL lavender top tube (K₂-K₃EDTA) peripheral blood is also acceptable.

Transport Instructions:

• Room temperature (20-25°C)

Specimen Stability

• Specimens in ACD may be held at room temperature (20-25°C) for up to 72 hours.
• Specimens in Na Heparin should be processed within 48 hours of collection.
• Specimens in K₂EDTA/K₃EDTA should be processed within 30 hours of collection.

All tubes must be properly drawn; partial draw may cause cell lysis and loss due to hypertonic osmotic changes.

Solid Tissue:

• Submit as much tissue as possible, avoiding necrotic area.  Cut the tissue into small pieces or thin slices and aseptically place in 20% NCS transport media (RPMI preparation provided by lab) within 24 hours of collection.

Transport Instructions:

• Refrigerated at 2-8°C

  Note:  If 20% NCS is not available, Hank’s balanced salt solution or another RPMI equivalent may be used.  Saline may be used only if the specimen is forwarded promptly to the lab.  Specimen must NOT be placed in any fixative (i.e. Formalin).

Body Fluids (except CSF): (Peritoneal, Bronchial Alveolar Lavage, Pericardial, Pleural, Ascites, Thoracentesis and apheresis products):

• At least 5 mL fluid is preferred.  For fluids with low cell counts, larger volumes will improve results.  Inoculate the fluid aseptically into 20% NCS (RPMI preparation provided by lab) transport media within 24 hours of collection.

Transport Instructions:

• Refrigerated at 2-8°C

  Note:  If 20% NCS is not available, Hank’s balanced salt solution or another RPMI equivalent may be used.

Cerebrospinal Fluid (CSF):

• Submit as much CSF as possible.  Sufficiency of specimen is dependent on cell count (at least 100,000 total cells are required to perform a very limited/targeted panel of 1-2 tubes).  The CSF sample should be collected in a sterile, tightly closed container.

Transport Instructions:

• Refrigerated at 2-8°C; should be sent to the laboratory immediately.

Process & Hold: The bone marrow, blood or tissue will be processed and retained for up to 3 days. In these cases, please mark "Process & Hold" on the requisition form. A processing fee may apply. The processed specimen will generally remain viable for 2-3 days, during which time the physician should contact the laboratory to request immunophenotyping or cancel the testing.

Clinical and Technical Support
Flow Cytometry and Cellular Immunology Laboratory
214-645-7080 or 1-877-887-8136 Ext.7080

Karén Peart, MT(ASCP)SH, Chief Medical Technologist
Nitin Karandikar, M.D., Ph.D., Co-Director
Franklin Fuda, D.O., Co-Director

Customer Service (214) 645-7057 or Toll Free (877) 887-8136