December 2010

ONLINE TEST GUIDE:
CONTACT US:
http://byblos.labmed.washington.edu/bcard/search.asp
TEL:
FEE SCHEDULE:
EMAIL:
Call Reference Lab Services at 1-800-713-5198
WEB:
1-800-713-5198
December 2010
[email protected]
www.depts.washington.edu/labweb
VIROLOGY NEWSLETTER:
www.depts.washington.edu/rspvirus
NON-PROFIT ORG.
U.S. POSTAGE
PA I D
SEATTLE, WA
PERMIT NO. 62
Reference Lab Services
University of Washington
PO Box 15290
Seattle, WA 98115-0246
U N I V E R S I T Y O F WA S H I N G T O N
ADDRESS SERVICE REQUESTED
December 2010
TEST CHANGE
Alpha 1 Antitrypsin, Stool
Sample
Amylase
Reflexive Testing
BCR/ABL, p210 Quantitative
New
Bone Marrow, Wright’s Stain
Collection
Fructosamine
Tube Type
Glucose Testing
Collection
Heavy Metal Screening
CPT Codes
AMYLASE
Hemoglobin, Plasma
Tube Type
Note: Herpes Simplex Typing
CPT Codes, Reporting
IL28 Genotype HCV IFN Response
New
Influenza PCR Panel, Epidemic
Sample
Levetiracetam
Reference Range
Manganese
Reference Range
Parvovirus B19 by PCR, Quantitative
Units
Troponin
Reference Range
Tryptase
Reference Range
NOTE: NO COURIER SERVICE
There will be no courier service and our Call Center office will be closed
on Christmas Eve day (Friday, December 24th) and New Year’s Eve day
(Friday, December 31st).
ALPHA 1 ANTITRYPSIN, STOOL
Specimen Collection: Random fecal specimens only.
Test Order Code:
RSA1A
Note:
For 24 hour samples, please order the Alpha
1 Antitrypsin Clearance, Feces & Serum
If the total amylase activity is > 100 U/L, a
reflexive fractionation by Immunoinhibition
is performed which reports both pancreatic
and salivary amylase activities.
BCR/ABL, P210 QUANTITATIVE
New Method for Quantitative BCR/ABL Testing for CML Patients
with b3:a2 or b2:a2 Fusion Genes (p210 Fusion Protein)
On December 1, 2010, the Molecular Hematopathology Laboratory
will be changing the methodology for our test for monitoring
patients who are being treated for chronic myeloid leukemia (CML)
and are known to have the b3:a2 or b2:a2 fusion gene producing
the p210 fusion protein. Our new method is a BCR-ABL real-time
RT-PCR assay performed on the Cepheid GeneXpert Diagnostic
system. This methodology will allow us to provide faster turn
around times and a greater than one log increased sensitivity over
our previous method. The presence or absence of BCR-ABL mRNA
will be reported. If the result is positive, the level of BCR-ABL
mRNA is reported as a ratio of BCR-ABL to total ABL expressed as
a percentage. We will issue a cumulative report including historical
data for the patient.
Blood is the preferred specimen for this assay. While most patients
show similar BCR-ABL levels in concurrent blood and bone
marrow specimens, some patients have consistent differences in
levels between blood and bonwe marrow. Therefore, alternating
specimen types during monitoring can be misleading.
Of note, this test will detect only the b3:a2 and b2:a2 fusion
genes, which encode the p210 protein. Other fusion forms are
not detected, including the e1:a2, which encodes the p190 fusion
protein associated with Philadelphia chromosome-positive acute
lymphoblastic leukemia. We will continue to offer our previous
quantitative methodology for patients known to have the e1:a2
fusion gene.
This test is not designed as a screening method for BCR-ABL
fusion genes at the time of diagnosis. Our qualitative BCR-ABL
assay is more appropriate for that purpose since it detects and
can distinguish the fusion genes encoding either the p210 or
p190 protein.
References:
Hughes, Timothy, et al. Monitoring CML patients responding
to treatment with tyrosine kinase inhibitors: review and
recommendations for harmonizing current methodology for
detecting BCR-ABL transcripts and kinase domain mutations for
expressing results, Blood, 1 July 2006, Vol. 108, No. 1, pp. 28 - 37.
Branford, Susan, et al. Desirable performance characteristics for
BCR-ABL measurement on an international reporting scale to
allow consistent interpretation of individual patient response and
comparison of response rate between clinical trials, Blood, 15
October 2008, Vol. 112, No. 8, pp. 3330 – 3338.
Radich, Jerald P. How I monitor residual disease in chronic
myeloid leukemia, Blood, 15 October 2009, Vol. 114, No. 16,
pp. 3376 - 3381.
2 UW Laboratory Medicine December 2010
Specimen
Collection: 10 mL blood in Lavender Top (EDTA) tubes
or
1 - 2 mL Bone Marrow (EDTA).
Unacceptable:
Specimens in green top tubes (heparin) or
specimens anticoagulated with heparin.
Specimen must be labeled with two identifiers
(i.e. name, date of birth, or patient ID number.)
GLUCOSE TESTING
INFLUENZA PCR PANEL, EPIDEMIC
Glucose:
Plasma or serum collected in green, gold or red
top tubes should be separated from the cells
within 2 h and stored refrigerated. Glucose
in such specimens is stable up to 16 h after
collection. Glucose specimens collected in
gray top tubes are stable up to 24 h without
separation or refrigeration.
Collection:
Nasal swab, nasal wash, BAL or Tracheal
aspirate (ETT) are acceptable samples.
Please refrigerate specimens. Samples
other than NP swab, nasal wash, BAL or
Tracheal aspirate must be approved by the
Lab Medicine resident. (206) 598-6190.
Test Order Code:
GLU
Test Order Code:
FLUPCR
Glucose, Fasting:
Plasma or serum collected in green, gold or red
top tubes for fasting glucose should be separated
from the cells within 1 h and stored refrigerated.
Glucose in such specimens is stable up to 16 h
after collection. Glucose specimens collected
in gray top tubes are stable up to 24 h without
separation or refrigeration.
Please include the most recent white
blood cell count.
Specimen Transport: Entire sample, refrigerated (do not freeze).
Send specimen in a labeled, leak-proof tube.
Wrap the tube in absorbent material and place
in a crush proof container. Complete and
send a Hematopathology requisition in a
separate plastic bag in the shipping container.
Specimens should be received within 24 hours of
collection. We strongly recommend against sending
specimens that will arrive Friday afternoons.
Ship to:
Hematopathology Laboratory, Room G7-800
SCCA Building
825 Eastlake Ave. E
Seattle, WA 98109
Test Order Code:
CPT codes: 83891, 83902, 83900, 83901, 83896 x2,
83912 – CPHDQ
New CPT Code:
83015
83902, 83900, 83901, 83896 x2,
83912 – CPHDQA
Old CPT Codes:
82300, 83018x2, 83655
Price:
$453.00 – CPHDQ
$391.00 – CPHDQA
Test Order Codes: CPHDQ, CPHDQA (add on testing)
BONE MARROW, WRIGHT’S STAIN
Collection:
Test order Code:
Bone Marrows must be scheduled with
Hematology laboratory by calling 206-598-6229
(UW) or 206-744-3128 (HMC). Please call for all
Marrows, including procedures where assistance
is not needed.
BMWROS
FRUCTOSAMINE
Specimen
Collection: We will only accept serum (red top or SST) for this
test as of 12/1/2010. We can no longer process
green top tubes.
Test Order Code:
RFRUCT
LEVETIRACETAM
Reference Range:
12.0-46.0 mcg/mL (trough concentration)
Test Order Code:
RLEVET
MANGANESE
Reference Range:
0-15 years: NEST (Not Established)
>15 years: 0.6 - 2.3 ng/mL
Plasma or serum should be separated from the
cells within 2 h and stored refrigerated. For
storage stability, see individual analytes. Gray
top tubes are unacceptable.
Test Order Code:
RMANG
BMP, COMP, COMPHF
Reference Range:
Units will now be reported as IU/mL.
Previous units were “copies per mL”
Test Order Code:
B19PCQ
Test Order Code:
GLUF
Glucose, Panel
HEAVY METAL SCREENING
PARVOVIRUS B19 BY PCR, QUANTITATIVE
TROPONIN
Reference Range:
HEMOGLOBIN, PLASMA
> 0.4 ng/mL indicates likely myocardial
infarction.
Specimen Collection: Preferred: 3 mL of blood in a lavender top tube.
TRYPTASE
Acceptable:3 mL blood in a blue top (citrate) tube.
Reference Range:
<11.5 ng/mL for both sexes.
Test Order Code:
PLHB
Test Order Code:
RTRYPT
Note: This test is designated by the performing
laboratory as being for investigational
use only.
Results should not be used for diagnosis
without confirmation of the diagnosis by
another medically established diagnostic
product or procedure.
HERPES SIMPLEX TYPING
Reference Range:
We will now report HSV-1 and HSV-2 as separate
results with an interpretive report.
CPT Codes:
87529 x 2
Test Order Code:
HSVTYP
IL28 GENOTYPE HCV IFN RESPONSE
Specimen Collection: 5 mL blood in Lavender top tube.
Unacceptable:
Green Top tubes
Specimen Transport: 5 mL whole blood (min. 1 mL); room temperature.
The laboratory must receive the sample within 48
hours of draw.
Frequency:
Once a week.
Test Order Code:
IL28
CPT Codes:
83891, 83898 x2, 83912
Price:
$493.00
3
ONLINE TEST GUIDE:
CONTACT US:
http://byblos.labmed.washington.edu/bcard/search.asp
TEL:
FEE SCHEDULE:
EMAIL:
Call Reference Lab Services at 1-800-713-5198
WEB:
1-800-713-5198
December 2010
[email protected]
www.depts.washington.edu/labweb
VIROLOGY NEWSLETTER:
www.depts.washington.edu/rspvirus
NON-PROFIT ORG.
U.S. POSTAGE
PA I D
SEATTLE, WA
PERMIT NO. 62
Reference Lab Services
University of Washington
PO Box 15290
Seattle, WA 98115-0246
U N I V E R S I T Y O F WA S H I N G T O N
ADDRESS SERVICE REQUESTED
December 2010
TEST CHANGE
Alpha 1 Antitrypsin, Stool
Sample
Amylase
Reflexive Testing
BCR/ABL, p210 Quantitative
New
Bone Marrow, Wright’s Stain
Collection
Fructosamine
Tube Type
Glucose Testing
Collection
Heavy Metal Screening
CPT Codes
AMYLASE
Hemoglobin, Plasma
Tube Type
Note: Herpes Simplex Typing
CPT Codes, Reporting
IL28 Genotype HCV IFN Response
New
Influenza PCR Panel, Epidemic
Sample
Levetiracetam
Reference Range
Manganese
Reference Range
Parvovirus B19 by PCR, Quantitative
Units
Troponin
Reference Range
Tryptase
Reference Range
NOTE: NO COURIER SERVICE
There will be no courier service and our Call Center office will be closed
on Christmas Eve day (Friday, December 24th) and New Year’s Eve day
(Friday, December 31st).
ALPHA 1 ANTITRYPSIN, STOOL
Specimen Collection: Random fecal specimens only.
Test Order Code:
RSA1A
Note:
For 24 hour samples, please order the Alpha
1 Antitrypsin Clearance, Feces & Serum
If the total amylase activity is > 100 U/L, a
reflexive fractionation by Immunoinhibition
is performed which reports both pancreatic
and salivary amylase activities.
`