Browsing Tag

Oncology

Advanced Technology Laboratory, Cytogenetics

Discontinuation of Low-Volume and Individual Fluorescence in situ Hybridization (FISH) Probes

Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the following FISH tests will no longer be offered:

• Prader-Willi/Angelman (15q11-q13) by FISH

Recommended test is Angelman/Prader-Willi mPCR

Smith Magenis (17p11) by FISH

• Williams (7q11,23) by FISH

If need arises for this test, please place an order for a Send out Genetics Miscellaneous and enter requested test in the comments. The testing will be sent out through Spectrum Health.

Any questions about referral testing may be directed to the Referral Department. Any questions or concerns regarding these changes may be directed to Dr. Salah Ebrahim in the Cytogenetics Laboratory. Continue Reading

Hemostasis/Coagulation

New Test: Factor VIII Chromogenic Assay

Effective July 1, 2021, the Coagulation Department within the Spectrum Health Regional Laboratory will go live with an in-house, bovine based, Chromogenic Factor VIII assay.

This assay, a photometric determination of Factor VIII activity, is useful for monitoring coagulation factor replacement therapy of selected extended half-life coagulation factor replacements and Emicizumab therapy, a recombinant, monoclonal antibody that restores the function of the missing activated factor VIII by bridging FIXa and FX. The action of Emicizumab interferes with all APTT clot based and human chromogenic based assays, leading to an overestimation of Factor VIII activity.  As such, the bovine based Chromogenic Factor VIII assay is recommended.  The Chromogenic Factor VIII activity also assists in the diagnosis of hemophilia A using a 2-stage assay, particularly when the 1-stage clot based assay is normal.

For questions about this test, please refer to the laboratory catalog or use the Contact Us link above.

TEST INFORMATION

Chromogenic Factor VIII Activity – Epic Code: LAB1230831 | Interface Code: 1230831 | CPT: 85240

General Information, Hemostasis/Coagulation

Update: Platelet Aggregation Studies

The Spectrum Health Regional Laboratory Coagulation Department will be going live with the Helena AggRam analyzer on February 3, 2021.  This analyzer uses platelet rich plasma to analyze human platelet aggregation which is measured by absorbance.  The following aggregating agents are used in these studies: Arachidonic Acid, ADP, Collagen, Epinephrine, and Ristocetin.

Patients for platelet aggregation studies should be resting, fasting, and non-smoking. Patients should avoid taking any prescription or over the counter medications known to affect platelet function for ten (10) days to two (2) weeks prior to the studies. For a list of medications known to have anti-platelet effects, click here. Continue Reading

Compliance & Safety, General Information, Immunochemistry, Main lab

Serum Kappa/Lambda Free Light Chain Assay Update

Effective September 28th, 2020, a new generation of the serum kappa/lambda free light chain assay has been implemented.

With the implementation of the new generation of the assay there is an approximately 20% negative bias for kappa free light chains in serum containing >20 mg/dL kappa free light chain.  This may affect the trending for patient who are serially monitored by this assay. Continue Reading

General Information, Immunochemistry, Test Utilization

Protein Electrophoresis Orderable Changes

As of August 26, 2020, the following tests will be obsoleted or made as lab orderables only.  This was implemented to streamline protein electrophoresis orders and ensure that patients receive the recommended testing for the assessment of plasma cell proliferative diseases.

In addition to streamlining protein electrophoresis orders, order questions have been implemented to the available tests to access the reason for ordering to ensure that the proper reflex testing is applied.

For more information, see the lab test directory under the available tests for a protein electrophoresis orders tip sheet entitled “Orders- Protein Orderable ChangesContinue Reading

Hemostasis/Coagulation

New Test: Thrombin Time

Effective March 4th, 2020, Thrombin Time will change from a sendout reference test performed by Mayo Clinic Laboratories to an in-house test performed by Spectrum Health Regional Laboratory. This test will be performed in the Coagulation Laboratory and will include a new reference range (please see link in Test Information below).

Thrombin Time is suitable for monitoring fibrinolysis therapy, screening for disorders of fibrin formation and in cases of suspected fibrinogen deficiency states. It is also useful for the differentiation between a heparin induced prolongation of the thrombin time and fibrin formation disorders.

For questions around this test, please contact the Coagulation Department at 616-267-2740.

TEST INFORMATION

Thrombin Time – Epic Code: #LAB11230581, Interface Code: #11230581, CPT: #85670

General Information, Immunochemistry, Main lab, Test Utilization

Protein Electrophoresis Testing Update

In December, serum and urine protein electrophoresis testing will be simplified and standardized.  The only testing available will be:

Protein electrophoresis, serum, IFE if indicated 

Protein electrophoresis, random urine, do IFE if indicated 

Protein electrophoresis, 24 hour urine, do IFE if indicated 

In addition, on December 5, 2019, a new panel will be added which reflects expert recommendations for first line testing for monoclonal gammopathy, including plasma cell myeloma and most cases of amyloidosis, called “Monoclonal Gammopathy Screen

Protein electrophoresis, serum, IFE if indicated 

Kappa and lambda free light chains  Continue Reading

General Information, Immunochemistry

Test Update: Beta-2 Glycoprotein 1 Antibodies

Effective November 5th, testing for Beta-2 Glycoprotein 1 antibodies (IgG and IgM, serum) will change from a reference send out test to Mayo Medical Laboratories to an in-house test available at Spectrum Health Laboratories.  This testing is useful for evaluation of patients of suspected antiphospholipid antibody syndrome.

In addition, a new Antiphospholipid Antibody Syndrome Panel will be added which allows for appropriate and complete testing for antiphospholipid antibody syndrome. This panel includes:

Lupus Screen

Cardiolipin IgG and IgM Antibodies

Beta-2 Glycoprotein 1 IgG and IgM Antibodies

Continue Reading

Advanced Technology Laboratory, Cytogenetics, Flow Cytometry, General Information, Molecular Diagnostics

Advanced Technology Laboratory plays an important role in Oncology

Spectrum Health Regional Laboratory (SHRL) was featured on EightWest on WOOD TV8 on Tuesday, August 30, 2016. Dr. Stephanie F. Williams, Division Chief of Spectrum Health Adult Bone and Marrow Transplant, and Kim Collison, Director of Laboratory Services, talk about the importance and benefits of having SHRL’s Advanced Technology Laboratory right here in West Michigan.

The Advanced Technology Laboratory is “extremely important, particularly for patients with certain cancers…”

“It helps us to diagnose the patients faster and more accurately; to follow the progress of their disease during the treatments that we give, and even at times to guide us in what is the best treatment for a patient…”

“Within 2 hours we had the answer. We did not have to send that specimen out to another laboratory in another state.”

-Stephanie F. Williams, MD, Division Chief, Spectrum Health Adult Bone and Marrow Transplant