PNH by Flow Cytometry

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General Information

Lab Name
PNH by Flow Cytometry
Lab Code
PNHFLO
Epic Ordering
PNH by Flow Cytometry
Description

NOTICE:

The University of Washington Hematopathology laboratory is currently receiving requests for flow cytometry testing that exceed our capacity. We anticipate that turnaround times will be delayed in a subset of MRD flow cytometry cases, and we will no longer be able to regularly provide STAT call backs for MRD flow cases. Additionally, UW Hematopathology is unable to accept flow cytometry reference testing from new clients and will be limiting service to a subset of current clients.

In Paroxysmal Nocturnal Hemoglobinuria (PNH), a clonal marrow stem cell population gives rise to circulating mature hematopoietic cells lacking the expression of a variety of different cell surface proteins whose common feature is their linkage to the cell membrane via a glycosyl-phosphatidyl-inositol (GPI) linkage, a linkage that is deficient in the PNH clone. Similar findings may also be seen in aplastic anemia and myelodysplasia, although the frequency of GPI-deficient cells is lower. GPI-deficiency is most easily assessed in the erythroid, granulocytic and monocytic lineages, and flow cytometry is the method of choice for their detection. The flow cytometric assay evaluates for a loss of expression of the following GPI-linked antigens: CD59 on red cells, CD14 and FLAER on monocytes, and CD24 and FLAER on granulocytes. The assay can detect as little as 0.01% GPI-deficient cells in each cell lineage.

References

Borowitz et al (2010) Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry. Cytometry Part B 78B:211 to 230.

Forms & Requisitions

Hematopathology Requisition

Synonyms
CD59, GPI deficient, Paroxysmal Nocturnal Hemoglobin
Components

Interpretation

Method

Flow Cytometry

Reference Range
See individual components
Interferences and Limitations

The assay is performed by flow cytometric immunophenotyping and interpreted by a trained hematopathologist. The assay has been validated for the diagnosis and monitoring of patients with hematopoietic neoplasms.

References

Borowitz et al (2010) Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry. Cytometry Part B 78B:211 to 230.

Guidelines

Ordering & Collection

Specimen Type
Peripheral Blood
Collection

Blood: 6 mL blood in LAVENDER top (EDTA) tube

Unacceptable: Bone Marrow, Formalin fixed, paraffin embedded specimens

Please note: Green top tubes are accepted for testing.

Forms & Requisitions

Hematopathology Requisition

Handling Instructions

Samples should be ambient and delivered to the laboratory without delay. Optimal results are achieved when samples are received within: 24-48 hours of collection

Samples submitted outside of this range will be evaluated for quality using appropriate internal controls and the results qualified appropriately.

Quantity
requested: 6 mL blood

Processing

Processing

Performance

LIS Dept Code
Hematopathology (HP)
Performing Location(s)
Other Hematopathology
206-606-7060

UW Hematopathology Laboratory, G7-800
Fred Hutchinson Cancer Center
825 Eastlake Avenue E.
Seattle, WA 98109

Hematopathology hours:
5:30 am - 6:30 pm Monday through Saturday
7:30 am - 4:00 pm Sunday, and with reduced staffing on major holidays

Frequency
Daily
Available STAT?
No

Billing & Coding

CPT codes
88184, 88185x7, 88187
LOINC
55164-8
Interfaced Order Code
UOW3462