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Test Code BM SPEC Bone Marrow Aspirate

Important Note

For detailed collection instructions (including tubes & volumes to collect) refer to Seattle Children's Clinical Policy/Procedure:  Bone Marrow Aspiration-Biopsy or Surgery Bone Marrow Specimen Handling Job Aide. 

For new or suspected new leukemia samples - ordering physicians need to contact pathologist on call to have bone marrow slides reviewed.

 

For marrows collected at off-site facilities: see instructions below under 'Processing - Off-Site Collection' and under 'Requisitions' for appropriate requisition.  Ordering physicians must contact pathologist on call before sending all samples (206) 987-2000. 

Clinical System Name

BM Specimen Tracking

Synonyms

Bone Marrow Morphology

Flow Cytometry

MRD

Acute Leukemia

 

Description

The bone marrow aspiration/biopsy is used to diagnose or rule out hematologic and/or oncologic diseases.  These tests are performed for staging and monitoring treatment for many hematologic and non-hematologic disorders and for bone marrow transplant patients pre- and post-transplant.  (see Seattle Children's Clinical Policy/Procedure: Bone Marrow Aspiration-Biopsy)

Sample Requirements

Specimen:  Bone Marrow

Container(s):  See comments

Preferred Vol:  Volume and tubes depend on tests ordered. See instructions below.

Minimum Vol:  See comments

Note: For detailed collection instructions (including tubes & volumes to collect for morphology, flow cytometry, and cytogenetics) refer to Seattle Children's Clinical Policy/Procedure: Bone Marrow Aspirate-Biopsy or Surgery Bone Marrow Specimen Handling Job Aide. Mix tubes well. Label each tube with patient label, specimen type (bone marrow asp), side (right or left) and pull number.

        

 

Processing Instructions

Reject due to:  n/a - send to lab

Spin:  N

Aliquot:  N

Temp:  RT

Storage location:  Requires immediate processing by CPA. CPA - Order "BM SPEC" and match with completed requisition. M - F until 1630, transport specimen, original requisition, and labels to 10th floor Cell Markers (station #280); call before tubing specimen to make sure there is someone available to do testing. After hours M - Sat and all day Sun and Holidays - Give BM to Core Hematology. If you have any questions, call the pathologist on call.

 

Completed requisitions will accompany all specimens from Hem Clinic. Surgery bone marrow requisitions are often sent days before they collect the sample. These requisitions are stored in the 'Bone Marrow binder' on the CPA bookshelf. When a Bone Marrow specimen arrives from surgery, it will arrive with a blue specimen information sheet. Please match up the blue sheet and sample with the requisition from the binder before delivering the sample/paperwork.

 

Off-site collection:  Keep specimen at room temperature and transport as soon as possible to Children's Lab. Please fill out the Bone Marrow/Malignancy (Off-site collection) - Flow, Morphology, Cytogenetics requisition. Please contact Laboratory at (206) 987-2102 with method of transport and shipping number.

 

SCH Processing:  Order "BM SPEC" and match with completed requisition.  Forward any outside bone marrow specimens for malignancy workup to Cell Markers Lab.  M - F until 1630 (or Sat after confirming Cell Markers staff is still here), transport specimen, copy of original requisition, and labels to 10th floor Cell Markers (station #280); call before tubing specimen to make sure there is someone available to do testing.

 

For off-site collection ONLY, after hours M - Sat and all day Sun and Holidays - Notify the Pathologist on call that an offsite bone marrow was received.  Give BM to Core Hematology.  Please do not reject bone marrow samples for stability -- each bone marrow sample will be evaluated on a case by case basis in consultation with pathologist.

Stability

Temperature Time
Room temp

PROCESS SPECIMEN WITHIN 2 HOURS

Note:  Off Hours delay of up to 6 hours has been approved in circumstances where there are no trained personnel at 2 hours but there will be during the next 6 hours. Morphological changes do occur over time and preference is given to the shortest delay in processing.

 

For COMMUNITY SERVICE SAMPLES/BONE MARROW COLLECTED AT OUTSIDE LOCATION:  Please do not reject bone marrow samples for stability - each bone marrow sample will be evaluated on a case by case basis in consultation with pathologist.

Refrigerated N
Frozen N

 

Availability

STAT Performed TAT
Y-notify pathologist

Monday - Friday 0800-1630; Other times as arranged through pathologist on-call.

Daily

 

Performing Laboratory

Seattle Children's Laboratory    

Department

Department:  Cell Markers

Phone Number: 206-987-2560

 

 

Reference Range

None specified
 

Methodology

Method:  Wright Stained Smears

Analytical Volume:  None specified

Limitations:  Peripheral blood dilution

CPT Codes

contact Laboratory Client Services at (206)-987-2617

Requisition

Complete & include copy of Clinical Information System (CIS) HemOnc Bone Marrow Requisition (cases to be evaluated by Seattle Children's Pathology) or Hematopoietic Transplant Marrow Requisition (specimens to be evaluated at Seattle Cancer Care Alliance), as appropriate.

 

For specimens collected off-site: complete & include Seattle Childrens Bone Marrow/Malignancy (Off-site collection) - Flow, Morphology, Cytogenetics requisition.