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Advanced Technology Laboratory, Molecular Diagnostics

Methods update on BCR-ABL1 t[9;22] RT-PCR testing

An updated BCR-ABL1 t[9;22] RT-PCR assay went live on Jan 31, 2018. The BCR-ABL major and minor fusion transcripts are measured and reported separately after this update. The quantities of BCR-ABL1 major breakpoints fusion transcripts (type e13a2 and/or e14a2) are detected by FDA approved QuantideX® qPCR BCR-ABL IS Kit and the result is calibrated and reported on the International Scale (%IS). The quantities of BCR-ABL minor fusion transcripts are detected by QuantideX qPCR BCR-ABL minor kit and the result is reported as BCR-ABL1 to ABL1 ratio (%). This update provides more precise and standard measurements of BCR-ABL fusion RNA and supports the consistency of patient care in t(9;22) positive CML patients during monitoring of treatment with Tyrosine Kinase Inhibitors (TKIs).

Questions may be directed to the Molecular Diagnostics Laboratory using the “Contact Us” link above.

Lab Catalog link: LAB3222022: BCR-ABL1 t[9;22] RT- PCR  

Referral/Sendouts, Toxicology

Toxicology Testing Updates – May 2018

As of May 8, 2018, the following tests are no longer performed by Spectrum Health Laboratory. These tests are now available through Mayo Medical Laboratories as a send out. Please note that the specimen collection for these tests may have changed. Please check the Laboratory Catalog for collection information.

Discontinued Test Code Discontinue Test Name Replacement Code Replacement Name
LAB752 Clomipramine Level LAB1230481 Clomipramine, Serum
LAB683 Ethosuximide Level LAB1230480 Ethosuximide, Serum

Questions may be directed to the Toxicology Department using the “Contact Us” link above.

Advanced Technology Laboratory, Flow Cytometry, General Information

PNH Flow Cytometry Test Results

High sensitivity flow cytometry testing for paroxysmal nocturnal hemoglobinuria (PNH) is a test done on patient’s peripheral blood to screen for the presence or absence of PNH clones and/or to follow PNH clonal populations.  The lower limit of detection of a PNH clone for the Spectrum Health laboratory has been validated as 0.01% (1:10,000) for red cells, 0.01% (1:10,000) for granulocytes and 0.1% for monocytes (1:1000).

The results from PNH flow cytometry testing can guide the clinical team in classifying a patient’s disease appropriately, analyzing the risk of disease progression, and choosing appropriate testing to monitor response to treatment. Therefore, the PNH flow cytometry test result will now include a pathologist’s interpretation based on the new recommendations given in Updated ICCS/ESCCA Consensus Guidelines for the Clinical Utility of Testing for GPI-Anchor Deficient Clones in Paroxysmal Nocturnal Hemoglobinuria (PNH) and other Bone Marrow Disorders (Accepted article by Dezern and Borowitz, doi: 10.1002/cyto.b.21608).

Referral/Sendouts, Test Utilization

Anti-Thyroglobulin Orders Received in Conjunction with Thyroglobulin Tumor Marker Orders

Effective immediately, Anti-Thyroglobulin (Anti-TgAb) requests if received in conjunction with Thyroglobulin Tumor Marker (Tg-TM) requests, will be canceled. Tg-TM tests are sent to Mayo Medical Laboratory; where both Tg-TM and Anti-TgAb are performed and resulted as part of the Tg-TM order. This is a laboratory best practice as anti-thyroglobulin autoantibodies (Anti-TgAb), which occur in 15% to 30% of thyroid cancer patients, could lead to misleading Tg results (falsely positive or falsely negative).

Questions may be directed to Dr. David Alter, using the “Contact Us” link above.

General Information

Faxing Orders to Outpatient Laboratories

Spectrum Health Regional Laboratory now has ONE centralized fax number to which you can send your lab orders! This means no more searching for the fax number for a particular draw site for your patient. We will enter the faxed orders into our system, making them available to ALL of our draw sites; so your patient will have access to their order at their favorite draw site and the added convenience of going to any draw site that they choose!

*The new fax line number is: 616-774-7696

 *If you are faxing an order for a patient that plans to go to a draw site immediately, please write “Patient En Route” on the order, so that it may be prioritized.

 * Please note: Specimen add-on orders (additional tests for specimens in-lab) are still faxed to 616-267-2751, as stated on the add-on form.

Microbiology, Test Utilization

Influenza Epidemic Testing Recommendations 2018

Influenza is currently widespread throughout the nation at epidemic proportions. During influenza epidemics, clinical assessment predicts the presence of influenza infection virtually as well as laboratory testing. Therefore, it is no longer necessary to perform viral testing on ambulatory patients who present with illness consistent with influenza before beginning antiviral treatment. Antiviral treatment for Influenza should be started as soon as possible to have a beneficial effect.

Shortages of supplies and medications frequently occur during Influenza epidemics. However, diagnosis of specific viral respiratory infection remains important for hospitalized patients.

Please follow the current recommendations:

  • Limit availability of viral transport media at ambulatory sites.
  • Emergency departments are to limit viral respiratory testing to patients expected to be admitted.
  • Do not perform testing for test of cure.

Thank you for your support during this time. Please direct any questions to Laboratory Services via the “contact us” link above.