haematology users' handbook - University College London Hospitals

HAEMATOLOGY AND BLOOD TRANSFUSION 

USER HANDBOOK

Table of Contents 

Table of Contents...................................................................................................................................................................................................... 2 

General Information .................................................................................................................................................................................................. 3 

Location ...........................................................................................................................................................................................................................................3 

Contact Numbers and Working Hours.............................................................................................................................................................................................3 

Urgent Requests..............................................................................................................................................................................................................................4 

Out-of-Hours Service (after hours Monday - Saturday, Sunday and Public Holidays). ..................................................................................................................4 

Medical Staff....................................................................................................................................................................................................................................5 

Near Patient Testing facilities (Point of Care Laboratories).............................................................................................................................................................6 

Phlebotomy Services .......................................................................................................................................................................................................................6 

Vacutainer Guide .........................................................................................................................................................................................................................7 

Completion of the request form .......................................................................................................................................................................................................8 

Sample Collection (phlebotomy)......................................................................................................................................................................................................8 

Sample Labelling .............................................................................................................................................................................................................................8 

Sample Transport to the Laboratory................................................................................................................................................................................................9 

Special Handling Requirements ......................................................................................................................................................................................................9 

Routine Haematology.............................................................................................................................................................................................. 10 

Blood Transfusion ................................................................................................................................................................................................... 13 

Routine Coagulation................................................................................................................................................................................................ 18 

Haemostasis ........................................................................................................................................................................................................... 20 

Special Haematology .............................................................................................................................................................................................. 25 

Flow Cytometry (HIV and Malignancy Cell Markers)............................................................................................................................................... 29 

Leukaemia Cytogenetics......................................................................................................................................................................................... 34 

HAEM-PD-UserHbook V8 Haematology and Blood Transfusion User Handbook Page 2 of 38 

Authors: Karen Orfinada (Senior Biomedical Scientist) 

Sally McDonald (Senior Biomedical Scientist) Authorised by: Dave Barnett Review Date: August 2015

General Information 

Location 

The Haematology and Blood Transfusion laboratories are located at 60 Whitfield St London W1T 4EU. Samples are sent from the main hospital to Specimen 

Reception via the ‘Pod’ system and sample deliveries made by courier or from other sites are made via a rear building entrance in Howland Mews. Near Patient 

Testing facilities for Haematology/Oncology patients are located on the Lower Ground Floor of the MacMillan Cancer Centre on Huntley Street. 

Contact Numbers and Working Hours 

Haematology General Manager 0203 44 78192 or x78192 9.00 – 17.15 Tuesday - Thursday 

Dave Barnett 

Training and Development Manager 0203 447 9887 or x79887 9.00 – 17.15 Monday - Friday 

Stefan Kunka 

Quality Compliance Coordinator 0203 447 9887 or x79887 9.00 – 17.15 Monday - Friday 

Susan Crouch 

Health & Safety Officer 0203 447 8533 or x78533 9.00 – 17.15 Monday - Friday 

Norma McQueen 

Routine Haematology & Coagulation 9.00 – 19.15 Monday – Friday 

9.00 – 13.30 Saturday 

9.00 – 13.00 Sunday 

Departmental Lead: Billy Janda 0203 447 8961 or 78961 9.00 – 17.15 Monday - Friday 

Routine Haematology & General Enquiries 0203 447 8961 or x78961 

Routine Coagulation 0203 447 8547 or x78547 

Out-of-hours Bleep 7060 

Blood Transfusion Laboratory 0203 447 8522/8523 or x78522/78523 9.00 – 19.15 Monday – Friday 

Out-of-hours Bleep 7060 9.00 – 13.30 Saturday 

9.00 – 13.00 Sunday 

Departmental Lead: Jenny Berryman 0203 447 8522/8523 or x78522/78523 9.00 – 17.15 Monday - Friday 

Blood Transfusion Training and Compliance Officer: Sangeeta Samuel 0203 447 8522/8523 or x78522/x78523 9.00 – 17.15 Monday – Friday 

MAJOR HAEMORRHAGE 




For a Major Haemorrhage at any time: dial telephone extension 2222 (or extension 32222 from the Heart Hospital) and state "Major Haemorrhage" to the 

switchboard operator to activate the UCLH Trust’s Major Haemorrhage Protocol. In the event of a telephone network failure: dial the Analogue Direct Telephone 

Line to Blood Transfusion *020 7 631 0267, or Emergency Mobile *0771 851 2912. 

Note, these telephone numbers are for emergency use only: any use of these lines for routine communication will be reported as a clinical incident. 

Haemostasis Laboratory (Specialised Coagulation) 0203 447 8549/8529 or x78549/78529 9.00 – 17.15 Monday – Friday 

Departmental Lead: Pamela Carr 0203 447 8545 or x78545 

Special Haematology (Haemoglobinopathies) 0203 447 8533 or x78533 9.00 – 17.15 Monday – Friday 

Departmental Lead: Norma McQueen 

Flow Cytometry (HIV and malignancy cell markers) 0203 447 9603 or 79603 9.00 – 17.15 Monday – Friday 

Departmental Lead: Naina Chavda 0203 447 8541 or x78541 

A limited Leukaemia Immunophenotyping service is available out-of-hours (subject to authorisation by a Haematology Consultant). 

; 

Leukaemia Cytogenetics 0203 447 9603 or 79603 9.00 – 17.15 Monday – Friday 

Samples are forwarded from the Flow Cytometry laboratory to external reference laboratories. Returned reports are scanned onto CDR. 

Urgent Requests 

Please contact the relevant laboratory during routine working hours, or Bleep 7060 outside routine working hours to alert laboratory staff to samples en route for 

urgent processing. 

Out-of-Hours Service (after hours Monday - Saturday, Sunday and Public Holidays). 

The Haematology Laboratory provides a 7 day / 24 hour restricted service outside of routine hours: a Biomedical Scientist can be contacted via the relevant 

Routine Haematology, Routine Coagulation or Blood Transfusion laboratory telephone extension number until 19.15 (see above), or via Bleep 7060 at any time. 

The following services are available out of routine working hours: 

• Full Blood Count (FBC), Erythrocyte Sedimentation Rate (ESR), Blood Film Examination, Malaria antigen testing. 

• Clotting Screen / Fibrinogen Assay / D-Dimers 

• Group and Antibody Screen for Pre-op/Crossmatch 

• Crossmatch 

• Pre-op sickle testing 

Bleep 7060 to discuss any urgent requests for any services that are not usually available out of routine working hours. 




Medical Staff 

Consultants 

Dr Marie Scully (Lead Clinician) 020 7025 7970 or 020 3447 9884 Email: nancy.moorcraft@uclh.nhs.uk 

Dr Kirit Ardeshna 020 3447 9443 or ext 79443 Fax: 020 3447 9911 Email: melissacrozier@uclh.nhs.uk 

Dr Hannah Cohen (via secretary) 020 3447 8563 or ext 78563 Email: christine.smith@uclh.nhs.uk 

Dr Bernard Davis 020 3447 9638 or ext 78538 Email: sarah.benn-hirsch@uclh.nhs.uk 

Dr Shirley D’Sa 020 3447 8028 or ext 78028 Fax: 020 3447 9911 Email: shirley.dsa@unclh.nhs.uk 

Dr Victoria Grandage 020 3447 5239 or ext 75239 Fax: 020 3447 5827 

Dr Rajeev Gupta 020 3447 8483 or ext 78483 Email: anne.evans@uclh.nhs.uk 

Dr Jonathan Lambert 020 3447 9443 or ext 79443 Email: melissa.crozier@uclh.nhs.uk 

Dr Emma Morris 020 3447 9712 or ext 79712 Fax: 020 3447 9571 Email: e.morris@medsch.ucl.ac.uk 

Dr Ri Liesner 020 3447 9884 or ext 79884 Email: nancy.moorcraft@uclh.nhs.uk 

Dr Karl Peggs 020 3447 9712 or ext 79712 Fax: 020 3447 9571 Email: k.peggs@ucl.ac.uk 

Dr Martin Pule 020 3447 8483 or ext 78483 Email: anne.evans@uclh.nhs.uk 

Dr Neil Rabin 020 3447 8028 or ext 78028 Email: ysabel.howard@uclh.nhs.uk 

Dr Farrukh Shah 020 3447 9638 or ext 79638 Email: sarah.benn-hirsh@uclh.nhs.uk 

Dr Kirsty Thomson 020 3447 9712 or ext 79712 Fax: 020 3447 9571 Email: suzie.knapton’uclh.nhs.uk 

Dr Sara Trompeter 020 3447 9638 or ext 79638 Fax: 020 3447 9911 Email: sarah.benn-hirsch@uclh.nhs.uk 

Dr Andres Virchis 020 3447 9712 or ext 79712 Email: suzie.knapton@uclh.nhs.uk 

Professor Anthony Glodstone 020 3447 1528 or ext 71528 Email: Anthony.goldstone@uclh.nhs.uk 

Professor Asim Khwaia 020 7679 6554 or ext 79456 Fax: 020 3447 9911 Email: joan.hammond@uclh.nhs.uk 

Professor David C Linch 020 3447 8483 or ext 78483 Fax: 020 3447 9911 Email: Melissa.crozier@uclh.nhs.uk 

Professor Stephen Mackinnon 020 3447 9712 or ext 79884 Email: s.mackinnon@ucl.ac.uk 

Professor John B Porter 020 3447 9638 or ext 79638 Email: sarah.benn-hirsch@uclh.nhs.uk 

Prof Kwee L Yong 020 3447 8028 or ext 78028 Fax: 020 3447 9911 Email: ysabel.howard@uclh.nhs.uk 

Dr. John Paul Westwood 0203 447 6854 or 020 3447 9884 or ext 79884 Email: nancy.moorcraft@uclh.nhs.uk 

Specialist Registrars (9.00 – 17.00 Monday – Friday) 

Haematology Laboratory SpR Bleep 7000 

Blood Transfusion Laboratory SpR Bleep 7050 

Haemostasis Laboratory SpR Bleep 7044 

On-call Haematology Registrar/SpR (out-of-hours) Contact via Switchboard 

Clinical advice 

During routine working hours (Monday – Friday 9.00 – 17.00), please contact the relevant laboratory Specialist Registrar via the bleep system. 

A Haematology Registrar/SpR is on call outside routine working hours: contact via the switchboard. 




Near Patient Testing facilities (Point of Care Laboratories) 

Haematology Point of Care Laboratories provide Full Blood Count results exclusively for Haematology/Oncology outpatients receiving chemotherapy or 

attending clinic appointments. 

MacMillan Cancer Centre (Huntley Street), Lower Ground Floor 0203 447 6855 or extension 76855 8.00 – 17.00 Monday-Friday 

Phlebotomy Services 

Phlebotomy Manager: Nahid Weaver 0203 447 0168 or x70168 7.30 – 16.30 Monday – Friday 

Inpatient Services 

University College Hospital 

Monday to Sunday 08:00 – 12:00 * 

Heart Hospital 

Monday to Sunday 08:00 – 12:00 * 

National Hospital for Neurology and 

Neurosurgery (NHNN) Inpatients 

Monday to Friday 08:00 – 12:00 * 

* Note: Outside of these hours, staff trained in phlebotomy 

must collect blood samples. 

Elizabeth Garrett Anderson wing (EGA) 

No inpatient service 

GP Service 

UCLH GP Blood Test Suite 

2 nd Floor, Mortimer Market Centre, 

Mortimer Market WC1E 6JB 

Mortimer Market runs off Capper Street, which is a side 

street off Tottenham Court Road (across from Howland 

Street). 

Monday to Friday 07:30 - 16:30 

Outpatient Services 

University College Hospital, 

1 st Floor Podium 

Monday, Tuesday, Thursday, Friday 08.30 – 16.30 

Wednesday 08.30 – 19.00 

Saturday, Sunday Closed 

Antenatal Clinic- UCH EGA wing 

(1 st Floor) 

Monday, Wednesday, Thursday 09:00 – 17:00 

Tuesday 09:00 – 13:00 

Friday, Saturday, Sunday Closed * 

(*samples collected by ANC staff). 

National Hospital for Neurology and 

Neurosurgery (NHNN) Outpatients 

Monday, Tuesday, Thursday, Friday 09:00 – 16:45 

Wednesday 09:00 – 18:00 


5 th Floor, Rosenheim Building 

Monday, Tuesday, Wednesday 08:30 – 16:45 

Thursday, Friday 08:30 – 16:30 


Diabetic Clinic (UCH Podium, 1 st Floor) 

Monday * 13:00 – 17:00 

• Clinics held every 2 nd Monday only 

(appointments arranged by Diabetic Clinic 

staff). 

Thursday 08:30 – 17:00 

Travel Clinic 

2 nd Floor, Mortimer Market Centre, 

Mortimer Market WC1E 6JB 

Mortimer Market runs off Capper Street, 

which is a side street off Tottenham Court 

Road (across from Howland Street). 

Monday – Friday 09:00 -16:30 

Appointment Wednesdays 13:00 -17:00 

Fridays 09:00 -13:00 





Vacutainer Guide 

Becton Dickinson 

Vacutainer 

Note : underfilled samples 

are unsuitable for testing. 

Ordering 

Information 

EDTA 

4.5 ml 

Sodium citrate (citrated 

tube) 

4.5 ml 

SST 

5ml 

Lithium Heparin 

4.5 ml 

Sodium citrate (citrate) 

1.0 ml 

Tests / Screens 

FBC, ESR, Reticulocyte count, IPF, Blood film (note: ESRs cannot be performed on 7ml EDTA tubes), 

Sickle screen, Malaria Antigen testing 

Glandular Fever testing (note, Glandular Fever testing can be performed on an SST sample), 

Lymphocyte subsets (including CD4, CD8 counts), Hereditary Spherocytosis Dye binding assay, 

Plasma Viscosity, PCR in Haemostasis 

Blood Transfusion 

*Group & Save (including antibody screen), *Crossmatch, Kleihauer, DAT 

*Sample identification for Group & Screen or Crossmatch MUST be hand written with 4 correct points of ID. 

Clotting screen / Fibrinogen / D-Dimers. These tubes must be filled exactly to the 4.5ml mark on the side of 

the tube: underfilled & overfilled samples are unsuitable for testing. 

For Paediatric Clotting Screens, see below. 

Citrated Platelet Count (alert Coagulation laboratory staff that the sample is en route: it must not be 

centrifuged). 

Specialised Haemostasis tests must be authorised by a Haematology/Haemostasis SpR/Consultant 

See the Haemostasis section below for the samples required for specialised Haemostasis tests. 

Cardiolipin antibodies (Antiphospholipid antibodies) 

β 2 GPI antibodies 

Haemoglobinopathy screen, G6PD assay, Pyruvate Kinase assay, Red Cell Osmotic Fragility, Globin Chain 

Biosynthesis, Oxygen Dissociation curve 

Cytogenetic chromosomal analysis and FISH. 

Paediatric Clotting Screen, Fibrinogen, D-Dimers (1ml tubes). 

Contact the Haemostasis laboratory for other Haemostasis tests for paediatric patients. 

These tubes must be filled exactly to the 1ml mark on the side of the tube: underfilled & overfilled samples 

are unsuitable for testing. 

These tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and 

Phlebotomy Outpatient Departments and can be issued to other locations on request: contact x78549 or 

x78545. Monday – Friday 09.00 – 17.15 




Completion of the request form 

Please use the appropriate request form for the tests required and ballpoint (indelible) ink pen to complete the form. 

• Please provide the patient’s full name, hospital number and date of birth. 

• Please provide the date and time of sample collection and relevant clinical information to facilitate sample processing and the interpretation of results. 

• Please use a separate Blood Transfusion request form for Blood Transfusion requests; Group & Save, Crossmatch, Kleihauer, DAT. 

• Please ensure that the destination of the report, the name of the requesting/responsible clinician and a contact bleep/telephone number for the 

responsible clinician is provided to enable laboratory staff to notify the clinician regarding unsuitable (urgent) samples and to relay and/or discuss urgent 

or grossly abnormal results. 

• Please tick the box next to the test(s) requested; if a required test is not listed, write it clearly into the “Additional Tests” section. 

• Please tick the appropriate box when the patient is anticoagulated (on warfarin or heparin). 

• If possible please provide clinical details. 

Please ensure that adequate samples are taken for the tests requested and that each sample is labelled correctly. Contact the relevant laboratory for clarification 

of sample requirements if required. 

Sample Collection (phlebotomy) 

The sample collection policy for staff trained in phlebotomy [Haem-PD-BloodSampColl] and guidelines for sample labelling are available on the UCLH Intranet 

and can be sent electronically to GP practices. 

Sample Labelling 

• Please label samples clearly with hospital number, first and last name and date of birth using a ballpoint (permanent/indelible) ink pen. The NHS number 

may be used in place of the hospital number for GP and non-UCLH Trust patients. 

• Samples for a Group and Save (including an antibody screen) and Crossmatching must be hand written with four correct points of ID. Please include the 

time and date of collection and the signature of the person collecting the sample. 

• A minimum of three points of identification must be provided for all other samples. 

NOTE: Samples received broken/leaking, inadequately labelled, aged, clotted, haemolysed or otherwise unsuitable for testing will not be processed; an 

appropriate comment will be entered onto the computer system. If the requested tests are urgent, laboratory staff will attempt to notify the ward/clinician. 




Sample Transport to the Laboratory 

UCLH samples: refer to the Pathology Specimen Transport and Pneumatic Tube System policies on the UCLH Intranet for hospital transport. Samples from GP 

practices must be sent via UCLH Trust transport; via the next available collection during the working day. If a significant delay in sample transportation to the 

laboratory is anticipated, please discuss with laboratory staff, as sample deterioration may limit the viability of results. 

Special Handling Requirements 

Please see the ‘Notes’ section in the test tables below, or contact the relevant laboratory for information regarding special handling requirements. 




Routine Haematology (page 1 of 3) 

Autolab. 1 st Floor, Whitfield St Laboratories, 60 Whitfield St London W1T 4EU 0203 447 8961 or x78961 (Haematology) Bleep 7060 (out-of-hours) 

0203 447 8547 or x78547 (Routine Coagulation) 

• Please contact the laboratory for reference range(s) if not listed below: 

Test 

Acanthocytes 

Specimen 

Type 

4.5ml EDTA 

(can be 

performed on 

same sample as 

FBC) 

Reference 

ranges 

Key Factors 

affecting tests 

0-3 % Delay in receiving 

sample 

Sample not kept at 

room temperature 

Notes 

Send sample ASAP to the 

laboratory as prolonged 

storage affects cell 

morphology 

Out of 

hours 

service 

No 

service 

provided 

Time Limit for 

requesting 

additional 

tests from 

time of 

venesection 

Within 24 

hours 

Turnaround time 

from receipt of 

sample 

12 hrs 

Blood Film 

Citrated Platelet 

Count (platelet 

clumping in EDTA) 

ESR 

4.5ml EDTA 

(can be 

performed on 


FBC) 

4.5ml Sodium 

Citrate 

4.5ml EDTA 

(can be 

performed on 


FBC) 

Not applicable 

Delay in receiving 

sample 


room temperature 

Send sample ASAP to the 

laboratory as prolonged 

storage affects cell 

morphology. 

Please give clinical details 

/ reason for request 

150-400 x10 9 /l Clot in sample Please indicate clearly on 

the request form that 

sample is for a citrated 

platelet count. Notify the 

Routine Coagulation 

Laboratory that the sample 

is en-route: do not 

centrifuge the sample. 

3mls. 

Cannot be performed on a 

7ml EDTA tube. 

Service 

for 

clinically 

urgent 

requests 

Service 

for 

clinically 

urgent 

requests 

Service 

for 

clinically 

urgent 

requests 

Within 24 

hours 

Within 24 

hours 

Within 24 

hours 

Urgent: 

4hrs (not 

out of hours 

unless the 

laboratory 

is 

contacted) 

8 hrs 

Urgent 

Nonurgent 

24 hrs 

Nonurgent 

2 hrs 24 hrs 





Test Specimen Type Reference 

ranges 

Fluid Count 

(e.g. Pleural, 

Ascitic, Knee fluid) 

Full Blood Count 

(FBC) 

Glandular Fever 

Screen 

Fluid to be 

taken into EDTA 

or 10 or 20ml 

sterile container 

4.5ml EDTA 

4.5ml EDTA 

Can be performed 

on FBC sample 

or a 4.5 / 7ml 

clotted sample 

Adult WBC: 

3-10 x10 9 l 

Neutrophils: 

2-7.5 x10 9 /l 

Haemoglobin: 

11.5-15.5g/dl (F) 

13-17 g/dl (M) 

MCV: 80-99 fl 

Platelets: 

150-400 x10 9 /l 

Key Factors 


Delay in receiving 

sample 

Clot in sample 

Insufficient, 

Lipaemic or 

Icteric samples 

Delayed sample 

receipt 


Notes 

Please use “Urine/other” 

request form-specify type of 

fluid 

> 1ml blood required 

Sample must be received 

within 12 hrs of collection 

Lipaemic/icteric samples can 

affect performance of test and 

may delay results 

Test can be added on to 

existing FBC sample (time 

limit: 7 days) 

Out of 

hours 

service 

Service for 

clinically 

urgent 

requests 

Service for 

clinically 

urgent 

requests 

No service 

provided 


requesting 

additional 

tests from 

time of 

venesection 

Within 24 

hours 

Sample must 

be received in 

the laboratory 

within 12 

hours of 

collection 

Within 7 days 



sample 

4 hrs 

Urgent: 

1 hr 

Urgent: 

2 hrs 

Nonurgent: 

8 hrs 

Nonurgent: 

24 hrs 

Immature Platelet 

Fraction 

Malaria Antigen 

Test 

4.5ml EDTA 


on FBC sample 

4.5ml EDTA 


on FBC sample) 



receipt 



existing FBC sample 

All samples for malaria 

antigen tests are referred to 

Parasitology for confirmation 

-Please send requests for 

malaria parasite films and 

% parasitaemia directly to 

Parasitology laboratory 

Service for 

clinically 

urgent 

requests 

Service for 

clinically 

urgent 

requests 

Within 24 

hours 

8 hrs 

Urgent: 

1hr 

Nonurgent: 

8 hrs 





Reticulocytes 

Sickle Screen 

Test Specimen Type Reference 

ranges 

4.5ml EDTA 


on FBC sample 

4.5ml EDTA 

(can be 

performed on 


FBC) 

Key Factors 


20-100 x 10 9 /l Clot in sample 


receipt 

Samples from 

children < 6 

months old can 

give false negative 

results 

Notes 


existing FBC sample (time 

limit: 24 hours) 

All samples for sickle screens 

are referred to Special 

Haematology for confirmation 

(if not previously confirmed) 

Out of 

hours 

service 

No service 

provided 

Service for 

clinically 

urgent 

requests 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Within 24 

hours 

Within 7 days 



sample 

8 hrs 

Urgent: 

1hr 

Nonurgent: 

24 hrs 

Anaemia 


Referral Laboratory (Malaria testing) 

Parasitology Laboratory 

Hospital for Tropical Diseases Building 

Capper St 

London WC1E 6JA 

0845 155 5000 ext 75418 




Blood Transfusion (page 1 of 5) 

1 st Floor, 60 Whitfield St London W1T 4EU 0203 447 8522 / 8523 or x78522 / 78523 (Routine hours) Bleep 7060 out-of-hours 

MAJOR HAEMORRHAGE (see page 4 of this user manual) 

• Samples and form MUST carry full and correct patient identification, i.e. handwritten forename, surname, date of birth and hospital number - requests 

made without these details will not be accepted. 

• Forms must be signed by both the requesting medical officer and the phlebotomist. The phlebotomist must sign and date the sample. Please provide a 

bleep number for enquiries. 

• Please refer to the Trust Blood Component Transfusion Policy and Procedure available on the UCLH Intranet. 

Test 

Crossmatch 

Specimen 

type 

4.5ml/7ml 

EDTA 

Key Factors affecting 

tests 

Incorrectly labelled, 

Insufficient, clotted and 

haemolysed samples will 

be rejected. 

Notes 

Contact laboratory to check whether 

valid Group & Save available in 

laboratory before sending sample. 

> 2ml required for adults 

>1ml required for neonates (


Test 

Direct 

Antiglobulin 

Test (DAT) 

Group & Save 

Specimen 

type 

4.5 /7ml 

EDTA 

4.5/7ml 

EDTA 

Key Factors affecting 

tests 

Insufficient, clotted and 

haemolysed samples will 

be rejected. 

Kleihauer 4.5ml EDTA Delay in receiving sample. 

Sample not kept at room 

temperature before 

performing test. 

Notes 

Can be added onto existing Group & 

Save or Haematology FBC sample 

>2ml required for adults 

>1ml required for neonates (


Test 

HLA typing 

Specimen 

type 

7-10ml EDTA 

(if white cell count 


Transport of Routine Blood and Blood Products 

Remote issue of red cells has been implemented at UCLH. This allows blood to be issued directly from the Remote Issue blood fridge at the point of care, rather 

than from the laboratory for most patients. 

A small percentage of patients will still need blood crossmatched by the laboratory but this can also be stored in the remote issue blood fridge and dispensed 

when required. 

FFP for patients will be sent to remote issue fridges by the laboratory and dispensed in the same way. 

Cross matched blood for patients with special requirements and those not eligible for remote issue and other blood products are dispatched as follows: 

• Non-urgent blood and blood products are dispatched from the laboratory at various times during the day. 

• Urgent blood and blood products are dispatched from the laboratory by courier (arranged by the laboratory). PLEASE CONTACT THE LABORATORY 

(x78523/78522 during routine work hours or Bleep 7060 out of hours) IF BLOOD IS REQUIRED URGENTLY. 

• FFP will be returned to the laboratory 24 hours after it has been thawed. 

• Unused platelets/FFP/Cryoprecipitate are withdrawn the day after the original date required 

• Cryoprecipitate should be used within 4 hours of thawing and any remaining units returned to the lab. 

*Always ring the laboratory before use of EMERGENCY UNCROSSMATCHED BLOOD* 





Guidelines for Clinical Situations 

1. Life threatening haemorrhage (acute massive blood loss) Massive obstetric haemorrhage 

Refer to the Major Haemorrhage Algorithm 

http://insight/departments/MedicineBoard/Pathology/HaematologyPathology/BloodTransfusion/Documents/Major%20haemorrhage%20algorithm.pdf 

For further Information refer to the Trust Major Haemorrhage Protocol 

http://insight/guidelines/Clinical%20guidelines/Major%20Haemorrhage%20Protocol%202012.pdf 

2. Non-acute bleeding and neonatal surgery 

Obtain: 

Contact: 

Coagulation screen and FBC 

Blood Transfusion Registrar 

Monday →Friday 09:00-17:00: 

UCLH Bleep 7050/7000 

All other times: 

General Haematology Registrar via UCLH switchboard 

Discuss: 

Appropriate treatment 

(If a high risk procedure, or the patient has a known coagulation abnormality, contact the Haemostasis Registrar prior to 

procedure and discuss the patient’s management) 

Monday →Friday 09:00 – 17:00 

All other times: 

Haemostasis Registrar UCH Bleep 7044/7000 

General Haematology Registrar via UCH Switchboard 

3. Indications for the transfusion of red cells, FFP, cryoprecipitate and platelets 

Please refer to the relevant chapter/appendix in the Trust Blood Component Transfusion Procedure Manual 

http://insight/guidelines/Clinical%20guidelines/Blood%20Transfusion%20Manual%202012.pdf 

4. Patients with Special Transfusion Requirements 

For patients who may require CMV negative blood products, Irradiated blood products, Washed red cells and/or HLA matched platelets: 

Please refer to the relevant appendix in the Blood Component Transfusion Procedure Manual. Ensure that the laboratory has received a Blood 

Transfusion Status Form by emailing BT Status or by faxing to fax number 0203 447 9587 before requesting blood products (this form can be downloaded 

from the Blood Transfusion site on the UCLH intranet). 




Routine Coagulation (page 1 of 2) 

Autolab 1 st Floor, Whitfield St Laboratories, 60 Whitfield St London W1T 4EU Tel: 0203 447 8547 or x 78547 

• Citrated samples must be adequately filled (a 9:1 blood:citrate sample ratio is required for all citrated samples). Tests cannot be performed on underfilled, 

overfilled, haemolysed or clotted samples. 

• Paediatric citrated tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and Phlebotomy Outpatient departments and 

can be issued to other locations on request: contact x78549/78545 during routine hours. 

• Include clinical details on the request form, e.g. “patient receiving Warfarin/Heparin therapy” or “post op”; to facilitate appropriate testing and 

interpretation of results. 

• Send the request form and sample to the laboratory as rapidly as possible; notify the laboratory regarding very urgent requests on ext 78547 (during 

routine working hours) or Bleep 7060 (out of hours). 

• Grossly lipaemic samples may require manual testing, potentially delaying results. 

• Abnormal results that require further laboratory investigation and/or manual testing/confirmation may be delayed. 

Test 

Coagulation 

screen 

PT/INR, APTT, 

TT, Fibrinogen 

Specimen 

type 

4.5ml Sodium 

Citrate 

Key Factors 


Heparin & 

Warfarin. 

Delayed receipt of 

sample. 

May not be 

possible on 

grossly lipaemic 

samples. 

Note Reference Range Out of hours 

service 

Heparin & warfarin 

therapy affects results 

and determines 

appropriate testing 

please indicate that the 

patient is on heparin 

and/or warfarin on the 

request form. 

PT: 10-12 secs 

APTT: 25-37 secs 

TT: 15.5-18.5 secs 

Fib: 1.5 – 4.0 g/L 

Service for 

clinically urgent 

requests 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

5 hours Urgent: 

1hr 



sample 

Nonurgent: 

4 hrs 




Routine Coagulation (page 2 of 2) 

D-dimers 

Test 

(Unfractionated) 

Heparin 

Monitoring: APTT 

ratio 

Specimen 

type 

4.5ml 

Sodium 

Citrate 

4.5ml Sodium 

Citrate 

Key Factors 



sample. 

Note Out of hours 

service 

This test can be added 

for an existing citrated 

sample. 

Please indicate Heparin 

therapy on the request 

form (tick box or 

handwrite). 

Normal cut off: 

0 – 0.55 mg/L FEU 

DVT/PE cut off: 

Haemostasis (page 1 of 6) 

2 nd Floor, 60 Whitfield St London W1T 4EU Hours: 09.00 – 17.15 Monday - Friday Tel: 0203 447 8545 / 8549, x78545 / 78549 

All Haemostasis tests must be requested/authorised by the Haemostasis SpR (Bleep 7044), Haematology SpR (Bleep 7000) or Haematology Consultant, with 

the exception of the following: 

• Cardiolipin Antibody testing; 

• Plasma Viscosity measurement; 

• Thrombophilia Screens from the Hyper Acute Stroke Unit (HASU) and the National Hospital for Neurology and Neurosurgery; 

• Antiphospholipid Antibody Screens from Rheumatology Outpatients (Professor Isenberg’s Clinic). 

Please discuss requests with Haemostasis laboratory staff if necessary, to ensure adequate samples are collected. 

• Citrated samples must be adequately filled (a 9:1 blood:citrate sample ratio is required for all citrated samples). 

• Tests cannot be performed on underfilled, overfilled, haemolysed or clotted citrated samples. 

• Paediatric citrated tubes are issued from the Haemostasis Laboratory to the Neonatal Unit, Paediatric A&E and Phlebotomy Outpatient departments and 

can be issued to other locations on request: contact x78549/78545 during routine hours. 

• Include clinical details on the request form to facilitate appropriate testing and interpretation of results. 

• Send the request form and sample to the laboratory as rapidly as possible; plasma must be processed within 5 hours of venepuncture. 

• For very urgent requests, notify the laboratory staff on ext 78549 / x78545 (during routine working hours) or Bleep 7060 (out of hours). . 

Test Specimen type Key Factors 

affecting 

tests 

Notes 

Reference 

Range 

Out of hours 

service 


requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample 

Antiphospholipid 

Antibody Screen / 

Lupus Screen 

incorporates Lupus 

Anticoagulant 

testing and 

Cardiolipin 

Antibody testing 

2 x 4.5 ml Sodium 

Citrate samples 

and 

1 x 5ml SST sample 

Warfarin, 

Heparin and 

Rivaroxaban 

therapy. 

Delayed 

receipt of 

sample 

(Lupus 

Anticoagulant 

test). 

Lupus Anticoagulant testing 

is inappropriate when 

patients are receiving heparin 

therapy. 

Contact the 

laboratory 

regarding 

Lupus 

Anticoagulant 

testing. 

Refer to 

Cardiolipin 

Antibody 

testing. 

No out of 

hours service 

Contact the 

Laboratory 

3 working 

days 







Anti-Xa assay 

For monitoring 

low molecular 

weight heparin - 

LMWH) therapy. 

β2 Glycoprotein 

1 Antibodies 

(B2GPI) 

Bleeding screen 

1) von 

Willebrand 

Factor 

Antigen 

2) von 

Willebrand 

Factor Activity 

1 x 4.5ml Sodium 

Citrated sample 

1 x 5ml SST 

sample 


Citrated samples 

Recommendation: 

also send an 

EDTA sample for 

a FBC. 

Delayed receipt 

of sample 

Heparin affects 

FVIII result. 


of sample. 

Notes 

Samples should 

be collected 4 

hours post an 

injection of Low 

Molecular Weight 

Heparin. 

A single SST 

sample is 

sufficient for 

ACLA & B2GPI 

Antibody testing. 

Reference 

Range 

Therapeutic 

range: 0.5 – 1.0 

IU/ml. 

Individual 

patient’s target 

range is a clinical 

decision. 

IgG: < 10 U/ml 

IgM: < 6 U/ml 

FVIII: 0.50 – 

2.00 IU/ml 

VWFAg: 0.50 – 

1.60 IU/ml 

VWFAct: 0.63 – 

2.00 IU/ml 

Out of hours 

service 

By agreement 

with the 

Haematology 

Consultant on call 

and subject to 

staff availability. 

No out of hours 

service 

Factor VIII only, 

by agreement 

with the 

Haematology 

Consultant on call 

and subject to 

staff availability. 


requesting 

additional tests 

from time of 

venesection 

Contact the 

Laboratory 

Contact the 

Laboratory 

Contact the 

Laboratory 



sample (in 

working days for 

non urgent 

requests) 

Urgent: 

12 hrs 

Non-urgent: 

5 working days 

3 working day 


3) Factor VIII 

assays 

4) Platelet 

Aggregation 







Notes 

Reference 

Range 

Out of hours 

service 


requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working 

days for non 

urgent 

requests) 

Platelet Aggregation 

studies 




also send an EDTA 

sample for a FBC) 

Aspirin affects 

platelet 

aggregation: 

testing is not 

recommended 

while patient is on 

aspirin. 


of sample. 

Samples must be kept at 

room temperature and 

received by the lab within 

1.5 hours of phlebotomy 

and before 1200 hrs. 

Contact the 

laboratory 

No out of 

hours service 

Tests must be 

performed 

within 5 

hours of 

venepuncture. 

1 working 

day 

Samples not kept 

at room 

temperature. 

Significant 

thrombocytopaeni 

a: aggregation 

studies only 

possible with an 

adequate platelet 

count 






affecting 

tests 

Notes 

Reference 

Range 

Out of hours 

service 


requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working 

days for non 

urgent 

requests) 

PFA-100 

(Platelet function 

analysis) 




also send an EDTA 

sample for a FBC) 

Aspirin affects 

results. 


sample. 


room temperature. 

The sample must be kept 

at room temperature & 

tested within 5 hours. 

Platelet Aggregation 

Studies must be requested 

separately if required. 

Contact the 

laboratory 

No out of 

hours service 

Contact the 

Laboratory 

1 working 

day 

Significant 

thrombocytopenia, 

anaemia, 

leucopaenia. 

Cardiolipin 

Antibodies (ACLA) 

1 x 5ml SST 

sample 

This test does not require 

authorisation. 

IgG: ≤ 12 

GPLU/ml 

No out of 

hours service 

3 working 

days 

IgM: ≤ 12 

MPLU/ml 

Plasma viscosity 

1 x 4.5ml EDTA 

sample 

Variations in 

temperature 


sample 

Samples must be kept at 

room temperature. 

Samples that have been 

refrigerated are unsuitable 

for testing. 

Samples should not be 

warmed, but warming 

does not make them 

unsuitable for testing 

1.4 - 1.75 

mPa 

By 

agreement 

with the 

Haematology 

Consultant 

on call and 

subject to 

staff 

availability. 

7 days 2 working 

days 






affecting 

tests 

Notes 

Reference 

Range 

Out of hours 

service 


requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample 

Factor Assays 

FVIII, FIX, FXI, FXII 

FII, FV, FVII, FX 

FXIII 

Lupus Anticoagulant 

test 

Dilute Russell’s Viper 

Venom Time test 

or Taipan Venom 

Time test (on 

warfarin). 

4.5ml Sodium 

Citrated samples – 

contact the 

laboratory for the 

number of samples 

required (dependent 

on tests requested). 



Heparin and 

Warfarin. 

Acute illness 

(contact the 

laboratory). 

Delayed 

receipt of 

sample 

Warfarin, 

Heparin and 

Rivaroxaban 

therapy. 

Delayed 

receipt of 

sample 

Required factor assays 

must be specified on the 

request form. 

Lupus Anticoagulant testing 

is inappropriate when 

patients are receiving 

heparin therapy. 

An SST sample is required 

if Cardiolipin Antibody 

testing is also requested. 

Contact the 

laboratory 

Factor VIII 

and Factor IX 

only: by 

agreement 

with the 

Haematology 

Consultant 

on call and 

subject to 

staff 

availability. 

No out of 

hours service 

Contact the 

Laboratory 

Contact the 

laboratory 

3 working 

days 

3 working 

days 

Heparin induced 

thrombocytopaenia 

(HIT) screen 

Heparin:PF4 

antibody assay 



(preferred) 

Urgent test: 

send the 

sample to the 

lab. 

Immediately. 

This test MUST be 

authorised by a 

Haematology Consultant 

(i.e. not a SpR): contact via 

the Haematology SpR 

(bleep 7044/7000) or 

switchboard out of hours. 

Contact the 

laboratory 

By agreement 

with the 

Haematology 

Consultant 

on call and 

subject to 

staff 

availability. 

Contact the 

Laboratory 

Urgent: 

1 working 

day 

Non-urgent: 

5 working 

days 






affecting 

tests 

Notes 

Referenc 

e Range 

Out of 

hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working 

days for 

non urgent 

requests) 

Thrombophilia screen 

Antithrombin, 

Protein C, 

Protein S, 

Lupus Anticoagulant, 

Cardiolipin Antibodies, 

Factor V Leiden, 

Prothrombin Gene 

Mutation, MTHFR 

mutation. 

Also Factor VII and X 

assays when patients 

are on warfarin. 

4 x 4.5ml 

Sodium 

Citrated 

samples 

+ 

1 x 5ml SST 

sample 

+ 

1 x 4.5ml 

EDTA 

Delayed 

receipt of 

sample. 

Plasma must 

be processed 

within 5 

hours of 

venesection. 

Warfarin and 

Heparin 

Acute illness 

may affect 

results of 

some tests 

These tests require authorisation 

unless the patient is a Haematology, 

NHNN or HASU patient: for all other 

patients, please contact the 

Haemostasis or Haematology SpR 

(bleep 7044 or 7000) for authorisation 

before taking samples. 

These tests can be requested 

individually. 

Samples for Factor V Leiden, MTHFR 

and Prothrombin Gene Mutation are 

sent from Haemostasis, UCLH to TDL 

Genetics 

Contact 

the 

laboratory 

Antithrombin, 

Protein C 

and Protein S 

only, by 

agreement 

with the 

Haematology 

Consultant 

on call and 

subject to 

staff 

availability. 

Contact the 

Laboratory 

3 working 

days 

Referral Laboratories: 

Special Haematology (page 1 of 3) 

For Nucleotides, PF1.2 and TAT (Thrombin 

antithrombin complex) 

Haemostasis Research Unit, 

Department of Haematology 

University College London Hospitals 

1 st Floor, 51 Chenies Mews 

London WC1E 6HX 

For VWF Multimers 

Haemophilia Centre and Thrombosis Unit, 

Ground Floor 

Royal Free Hospital 

Pond Street 

London NW3 2QG 

For Factor V Leiden, Prothrombin Gene 

Mutation and MTHFR Mutation 

TDL Genetics 

3 rd Floor 

60 Whitfield Street 

London W1T 4EU 

2 nd Floor, 60 Whitfield St London W1T 4EU Hours: 09.00 -17.15 Monday – Friday 0203 447 8533 or x78533 




• Haemoglobinopathy & Haemolytic Anaemia investigations 

• Reference ranges are provided on the report and on the IT system. 



Notes 

Out of 

hours 

service 


requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working days) 

Haemoglobinopathy 

screen 

4.5ml EDTA/Lithium 

heparin + sample for 

FBC 

Age of sample Can be performed on FBC 

sample 

No service 

currently 

Within 7 days 

Urgent: 

2 hours if no 

further testing 

required 

%Hb S levels 

4.5ml EDTA/Lithium 

heparin 

Can be performed on FBC 

sample 

No service 

currently 

Within 7 days 

Non urgent: 

72 hours if no 

further testing 

required 

Urgent: 

2 hours 

G6PD levels 

Pyruvate Kinase 

levels 

4.5ml EDTA or 

Lithium heparin 

4.5ml Lithium 

heparin 

Sample not stored 

at 2-6 °C 

Sample not stored 

at 2-6 °C 

Recent blood transfusion can 

invalidate the result. Please 

indicate if patient has been 

transfused recently. 

Recent blood transfusion can 

invalidate the result. Please 

indicate if patient has been 

transfused recently. 

No service 

currently 

No service 

currently 

Within 7 days 

Within 7 days 

Non urgent: 

24 – 48 hours 

Urgent: 

2 – 4 hours 

Non urgent: 

24 – 48 hours 

Urgent: 

24 hours 

Non urgent: 

24 – 48 hours 







Notes 

Out of 

hours 

service 


requesting 


from time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working days) 

Haemoglobin H stain 

4.5ml EDTA or Lithium 

heparin 

Age of sample 

Samples greater than 48 hours 

old are unsuitable for this test. 

No service 

provided 

24 hours 24 – 48 hours 

Heinz Body 

Preparation 

4.5ml EDTA or Lithium 

heparin 

Age of sample 



No service 

provided 

48 hours 72 hours 

Hereditary 

Spherocytosis 

Dye Binding Assay 

4.5ml EDTA Age of sample Please arrange with laboratory 



No service 

provided 

Within 8 hours 

72 hours 

Red Cell Osmotic 

Fragility 

Red Cell Oxygen 

Dissociation 

Globin Chain 

Biosynthesis 

4.5ml Lithium heparin Please arrange with laboratory No service 

provided 

4.5ml Lithium heparin Please arrange with laboratory No service 

provided 

3 x 4.5ml Lithium 

Please arrange with laboratory No service 

heparin (10ml blood 

provided 

required) 




72 hours 

48 hours 

Urgent 


Non urgent 

10 working 

days 

Haemoglobinopathy 

DNA and 

Haemochromatosis 

Erythropoietin 

2 - 4 x 4.5ml EDTA 

(10 - 20ml blood 

required) 

7ml clotted sample (no 

anticoagulant) 

Referred to Haemoglobinopathy 

Genetics, UCLH 

Via Haematology consultant. 

Referred to Kings College 

Hospital 

No service 

provided 

No service 

provided 

Additional 

samples are 

required for test. 

Additional 

samples are 


2-20 working 

days 

10 -15 working 

days 







Notes 

Out of hours 

service 


requesting 


from time of 

venesection 

Turnaround 

time from 

receipt of 

sample 

Soluble Transferrin 

Receptor assay 

7ml clotted sample Via Haematology Consultant. 

Referred to Kings College 

Hospital 

No service 

provided 

Additional 

samples are 


4-8 weeks 

Transcobalamin 7 ml clotted sample Referred to Royal Free Hospital. 

Sample must be separated within 

2 hours. Referred to Royal Free 

Hospital 

No service 

provided 

Additional 

samples are 


4-6 weeks 

Liver Dry Iron 

Estimation 

Biopsy sample in 

Formalin 

Referred to Royal Free Hospital. 

No service 

provided 

Additional 

samples are 


2-6 weeks 

Referral Laboratories: 

Haemoglobinopathy Genetics 

86-96 Chenies Mews 

London WC1E 6HY 

08451 555 000 ext 5230 

Department of Clinical 

Chemistry 

Kings College Hospital 

Denmark Hill 

London SE5 9RF 

0207 737 4000 ext 3501 

Special Haematology 


Pond Street London NW3 2QG 

0207 794 0500 ext 33413 

For Paroxysmal Nocturnal 

Haemoglobinuria (PNH): 

Haematological Malignancy 

Diagnostic Service 

Level 3 Bexley Wing 

St James University Hospital 

Beckett Street 

LEEDS LS9 7TF 

, 




Flow Cytometry (HIV and Malignancy Cell Markers) (page 1 of 5) 

2 nd Floor, 60 Whitfield St, London W1T 4EU Hours: 09.00 – 17.15 Monday - Friday Tel: 0203 447 9603 or x 79603 

• Please see report or telephone laboratory for reference ranges 

Test Specimen Type Key 

Factors 

affecting 

tests 

Notes Out of hours service Time Limit for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working days) 

Acute Leukaemia 

screen. This includes 

Myeloperoxidase stain, 

Esterase stain and Tdt. 

Bone Marrow in EDTA 

(can be performed on 

peripheral blood if 

bone marrow is not 

available) 

No minimum volume. 

Analysis can also be 

carried out on CSF, 

pleural and ascites 

fluid. 

Sample not 

kept at 

room 

temperature 

Pleural, 

Ascites and 

CSF 

samples not 

being spun 

onto slides 

within 12 

hours of 

being taken. 

Please discuss with 

Haematology SpR (Bleep 

7000/7001) before sending. 

Please send samples 

directly to Flow Cytometry 

laboratory. 

Please let flow cytometry 

laboratory know to expect 

sample. 

Transport samples at room 

temperature. 

The service at weekends 

and Bank Holidays is for 

new acute leukaemia 

screens only and must be 

backed by Consultant 

Haematologist. Contact 

Laboratory on-call bleep 

7060. Clinical staff must 

be available for 

interpretation of results as 

this will not be provided by 

laboratory staff. 

Within 24 

hours 

Urgent: 

Results can be 

sent out within 

a 8 hours after 

being received 

in laboratory 

Non-urgent: 

48hrs. 

Chronic Leukaemia 

screen 

Peripheral Blood in 

EDTA 

Can be performed on 

BM, CSF, pleural fluid 

and Ascites fluid. 


Sample not 

kept at 

room 

temperature 

Please send samples 

directly to flow cytometry 

lab. 



the samples. 


temperature. 

No service provided Within 24 

hours 

Urgent: 

Results can be 

sent out within 

a few hours 

after being 

received in 

laboratory 

Non-urgent: 

48hrs. 




Flow Cytometry (HIV and Cell Markers) (page 2 of 5) 


Factors 

affecting 

tests 

Notes 

Out of hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working days) 

Lymphoma screen 

Bone Marrow or 

Peripheral Blood 

(Can be performed on 

existing FBC sample) 


Sample not 

kept at 

room 

temperature 

Please send samples directly to 

flow cytometry lab. 



sample. 


temperature. 


hours 

Urgent: Results 

can be sent out 

within a few 

hours after being 

received in 

laboratory 

Non-urgent: 

48hrs. 

Bone Marrow staining 

8 x bone marrow 

smears 

If BM in 

EDTA has 

been 

received 

instead of 

slides 

The laboratory registrar / SHO 

should be contacted for bone 

marrow requests. Slides must be 

labelled in pencil with at least 3 

points of patient id and the date of 

sampling. 

BM received out of 

hours are not 

stained. If BM are 

urgent and need to 

be looked at out of 

hours, please bleep 

on-call laboratory 

staff to let them 

know to stain slides. 

Within 24 

hours 

Urgent ( i.e. 

Acute 

Leukaemia): 

1hr for staining + 

same day for 

reporting by 

Haem 

SpR/consultant 

Non-urgent: 

24hrs for staining 

+ further 4 


reporting by 

Haem 

consultant/ 

SpR 






Factors 

affecting 

tests 

Notes 

Out of hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working days) 

Lymphocyte subsets for 

HIV monitoring and for 

haematology patients. 

1 x 4.5ml EDTA 

(Can be performed on 

existing FBC sample) 

Clotted 

sample 

Sample not 

kept at 

room 

temperature 

Please discuss all HIV negative 

requests with Haem SpR (Bleep 

7000/7001) 

Samples should be



Factors 

affecting 

tests 

Notes 

Out of hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working days) 

Cerebrospinal Fluid 

(CSF) cytospin 

CSF in 10/20ml sterile 

container 

No minimum volume 

Sample not 

kept at 

room 

temperature 

Please ensure samples arrive in 

laboratory no later than 1630hrs. 

(If white cells are seen upon 

microscopic examination of 

cytospin slides, they are referred 

to Haem SpR for verification) 

All CSF requests 

received out of 

hours will be partially 

processed but not 

reported. If they 

need to be looked at 

out of hours the oncall 

lab staff need to 

be contacted. 

Within 24 

hours 

24hrs 

(same day) 

Iron stain 

8 x Bone Marrow 

Slides 

If BM in 

EDTA has 

been 

received 

instead of 

slides 

Slides must be labelled in pencil 

with at least 3 points of patient id 

and the date of sampling. 


hours 

Urgent ( i.e. 

Acute 

Leukaemia): 

1hr for staining + 

same day for 

reporting by 

Haem 

SpR/consultant 

Non-urgent: 

24hrs for staining 

+ further 4 


reporting by 

Haem 

consultant/ 

SpR 






Factors 

affecting 

tests 

Notes 

Urinary Haemosiderin 10mls urine None Haemosiderin can persist in the 

urine for weeks following a 

haemolytic episode 

Out of hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 


hours 

Turnaround 

time from 

receipt of 

sample (in 

working days) 

48 hrs + 2 


report by Haem 

SpR 

Pleural or Ascites fluid 

1ml fluid in sterile 

container 

If sample is 

more than 

24 hours 

Please contact flow cytometry 

staff when sending. 


hours 

24 hours. 




Leukaemia Cytogenetics (page 1 of 5) 

2 nd Floor, 60 Whitfield St London W1T 4EU Hours: 09.00 – 17.00 Monday - Friday Tel: 0203 447 9603 or x 79603 

• All samples for Leukaemia Cytogenetics are sent from the Flow Cytometry Laboratory to referral Laboratories. 

Test 

Specimen 

type 

Key Factors 


Notes 

Out of 

hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working 

days) 

Cytogenetic (chromosomal analysis) 

-Testing for suspected haematological 

disease disorders 

(at presentation, post therapy or bone 

marrow transplant). 

Aplastics/ general anaemia 

Acute Myeloid Leukaemia – 

M1,M2,M3,M4,M4Eo,M5 

A.L.L 

Burkitt’s Lymphoma 

CLL 

CML 

Diffuse Large B cell Lymphoma 

ET 

Follicular Lymphoma 

Mantle cell lymphoma 

MDS (CMML/RA/RARS/RAEB) 

Myelofibrosis 

Multiple Myeloma 

MPD (ET/Polycythaemia) 

NHL 

Pancytopenia 

Plasma cell Leukaemia 

PRV 

Thrombocytopenia/Neutropenia 

Bone Marrow 

Peripheral 

Blood: 

5-10ml 

Samples 

should be in 

Lithium 

Heparin or 

Cytopots 

(RPMI 1640 + 

Heparin 

medium). 

Except for 

CD138+ 

isolated 

plasma cells 

for FISH on 

multiple 

myeloma 

cases. 

Poor sample 

quality (clotted 

or more than a 

day old) 

Sample 

transported and 

or stored above 

or below room 

temperature 

Sample 

Contaminated 

by bacteria 

Sample taken 

into wrong 

transport 

medium 

Sent to: Great Ormond Street 

Hospital, Paediatric 

Malignancy Unit (PMU) 

Samples must be received 

before 2pm (Monday-Friday) 

for samples to get to PMU on 

the same day. 

Analysis will be carried as 

appropriate or in consultation 

with the referring Consultant 

or Registrar. 

The samples may be left 

overnight at room temperature 

and delivered to laboratory 

immediately the following 

morning. 

No 

service 

provided 

N/A 

Urgent 

referrals: 

10 working 

days 

Routine 

requests: 

15 working 

days 







Notes 

Out of 

hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working 

days) 

Cytogenetic FISH (Fluorescent 

Insitu Hybridisation) Analysis 

-Testing for suspected 

haematological disease disorders 

(at presentation, post therapy or 

bone marrow transplant). 

Aplastic anaemia 

AML-M1,M2,M3,M4,M4Eo,M5 

A.L.L 

Burkitt’s Lymphoma 

CLL 

CML 

Diffuse Large B cell Lymphoma 

ET 

Follicular Lymphoma 

Hypereosinophilic Syndrome 

Mantle cell lymphoma 

MDS 

Multiple Myeloma 

MPD (ET/Polycythaemia) 

NHL 

Plasma cell Leukaemia 

PRV 

As above 

Bone Marrow or 


in EDTA for FISH 

only. 

CD138+ isolated 

plasma cells for 

FISH on multiple 

myeloma cases is 

preferable 

however bone 

marrow samples 

may also be 

adequate. 

Poor sample 

quality (clotted 

or more than a 

day old) 

Sample 

transported 

and or stored 

above or below 

room 

temperature 

Sample 

Contaminated 

by bacteria 

Sample taken 

into wrong 

transport 

medium 


Hospital, Paediatric Malignancy 

Unit (PMU) 

Samples must be received before 

2pm (Monday-Friday) for samples 

to get to PMU on the same day. 


appropriate or in consultation with 

the referring Consultant or 

Registrar. 

The samples may be left 

overnight at room temperature 

and delivered to laboratory 

immediately the following 

morning. 

No 

service 

provided 

N/A 

Rapid FISH: 

3 working 

days 

Urgent 

referrals: 

10 working 

days 

Routine 

requests: 

15 working 

days 






affecting 

tests 

Notes 

Out of 

hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working 

days) 

JAK-2 mutation analysis 

Peripheral 

Blood/Bone 

Marrow in EDTA 


Hospital, Paediatric Malignancy 

Unit (PMU) 

No 

service 

provided 

N/A 

10 working 

days 

Samples must be received before 

2pm (Monday-Friday) for samples 

to get to PMU on the same day. 


appropriate or in consultation with 

the referring Consultant or 

Registrar. 

PCR 

• BCR/ABL 

• Ph+ve ALL 


in 10-20ml EDTA 

The samples may be left overnight 

at room temperature and delivered 

to laboratory immediately the 

following morning. 

Sent to: Imperial College Molecular 

Pathology Laboratory 

Hammersmith Hospital 

Samples will be sent the following 

day if received after 2pm. Samples 

need to arrive before midday on 

Fridays and prior to bank holidays 

which span a weekend 

No 

service 

provided 

N/A 

10 working 

days 





Test Specimen type Key 

Factors 

affecting 

tests 

Notes 

Out of 

hours 

service 

Time Limit 

for 

requesting 

additional 

tests from 

time of 

venesection 

Turnaround 

time from 

receipt of 

sample (in 

working 

days) 

PDGFR receptor 

Peripheral 

Blood/Bone 


Sent to Wessex Regional Genetics 

Laboratory, Salisbury District Hospital 

Samples will be sent the following day 

if received after 3pm. Samples need 

to arrive before midday on Fridays 

and prior to bank holidays which span 

a weekend 

No 

service 

provided 

N/A 

10 working 

days 

• Chimerism Studies 

• T-cell receptor 

rearrangement 

Peripheral 

Blood/Bone 


Sent to: Department of Haematology, 






a weekend 

No 

service 

provided 

N/A 

10 working 

days 

CLL 

• MRD 

• IgVH 

Peripheral 

Blood/Bone 


Sent to HMDS, 






a weekend 

No 

service 

provided 

N/A 

10 working 

days 





Referral laboratories: 

Paediatric Malignancy Unit 

Level 2 Camelia Botnar Laboratories 

Great Ormond Street Hospital 

Great Ormond Street 

London WC1N 3JH 

Haematological Malignancy Diagnostic Service 

(HMDS) 

St James Institute of Oncology 

Level 3 Bexley Wing 


Breckett Street 

Leeds. LS9 7TF 

Imperial College Molecular Pathology 

Laboratory 

G-block 2 nd floor, D2.04 

Hammersmith Hospital 

Du Cane Road 

London W12 0HS 

Wessex Regional Genetics Laboratory 

Salisbury District Hospital 

Odstock Road 

Salisbury 

Wiltshire SP2 8BJ 

Department of Haematology 


Pond Street 

Hampstead 

London NW32QG

haematology users' handbook - University College London Hospitals

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