Samples and Transport

Instructions for Cytogenetics Testing

General Information on Transportation of Specimens

  1. Transport media (for Bone Marrow and fresh tissue collection)
    • Request media by calling 604-877-6000 Ext 67-2094;
    • Refrigerate at 4°C upon receiving;
    • Do not use if past expiry date.
  2. Pre-book all requests for chromosome analysis on Bone Marrow or Tissue Biopsy with the Cytogenetics lab (604 877 6000 Ext 67-2094). MUST notify the lab to arrange shipping/receiving of specimen.
  3. Avoid arrival of the specimen on Friday afternoon, weekends and statutory holidays.
  4. Shipping Address:
    Hematological testing:
    Cancer Genetics Lab, Room #3305
    British Columbia Cancer Agency
    600 West 10th Avenue
    Vancouver BC V5Z 4E6
    Solid Tumour testing:
    Department of Pathology, Room #3225
    British Columbia Cancer Agency
    600 West 10th Avenue
    Vancouver BC V5Z 4E6
  5. Deliver to BCCA-VCC by air, taxi or courier service. Mark the shipping box clearly with the label provided.

Special Requirements on Collection of Specimens

  1. Bone Marrow Collection:
    • Add 1.0 mL of marrow from the first aspirate to the first media tube
    • Add 1.0 mL of marrow from the second aspirate to the second media tube
    • Label the tubes accordingly, wrap lids with Parafilm
    • Ensure the caps are tightened securely
    • Mix well
    • Ship to the lab at room temperature immediately
  2. Fresh Tissue Biopsy:
    • Should be stored in transport media and kept at 4°C (Do not freeze)
    • Ship to the lab immediately.
  3. To rule out CML by FISH: 4 mL of peripheral blood in Sodium Heparin.
  4. To rule out APL with t(15;17): Bone Marrow aspirate in transport media tube and 4 mL of Peripheral Blood in Sodium Heparin.
  5. Multiple Myeloma predictive marker panel: Bone Marrow aspirate in transport media
  6. CLL predictive marker panel: 4 mL of Peripheral Blood in Sodium Heparin

Special Requirements on Chromosome (Karyotype) Analysis:

A Bone Marrow report or Pathology report must be submitted in order to proceed with chromosome analysis. Cytogenetic analysis will proceed only if there is a proven, or high suspicion of, neoplastic process in the specimen. Fax marrow/pathology reports to 604-877-6294 ASAP (preliminary reports accepted).

Minimum Requirements for FISH Testing on Paraffin Tissue

  1. Selection of the tissue/core area for analysis should be performed by a pathologist. The site selected should be representative of viable tumour tissue with areas of necrosis, hemorrhage, poor fixation, or histological artifacts excluded.
  2. An H&E slide with the designated area circled by the requesting physician in felt marker must accompany the tissue block. Indicate on the requisition an estimate of the tumour content within the circled area (i.e. the proportion of all nucleated cells within the circled area that are tumour).
  3. Coring for isolated nuclei provides most accurate signal enumeration.
  4. Requirements for tissue sections:
    • Each unstained section should be cut between 5-6 µm thick and applied to a positively charged slide to minimize the incidence of tissue sections falling off the slides during processing. A thickness less than this will result in increased truncation of nuclei affecting established cut off values, and a greater thickness will result in poor probe hybridization.
    • The cut section should be placed centrally and as horizontally as possible onto the slide.
    • Ensure that the slide is appropriately labeled with patient name and pathology number.
    • Send slides in appropriate slide holders to prevent damage to the section during transit to the lab.
    • A completed requisition form including pathology number must accompany the patient sample.
  5. Specimen Return: Blocks and H&E slides will be returned as soon as the report is finalized.

Instructions for Molecular Genetics Testing

General Information on Collection and Transportation of Specimens

  1. Peripheral Blood (PB) and Bone Marrow (BM):  Collect in EDTA Tube(s) for Molecular Genetic test.  Ship at ambient temperature (Do NOT Spin or Freeze).
  2. Tissue Biopsy:  Keep frozen on dry ice.
  3. Fresh samples:  Collect Monday through Thursday. Must be shipped to the lab as soon as  possible and received within 48 Hours after collection.
  4. Paraffin samples (Formalin-fixed paraffin embedded tissue should be sent with a copy of the pathology report.)
    1. Paraffin blocks:  All blocks will be returned as soon as the result is reported.
    2. Paraffin scrolls:  Must be collected in sterile 1.7 mL Eppendorf tube. Necessary precautions must be taken to avoid specimen cross contamination or contamination by skin enzymes.  The tube containing scrolls must be labeled with the patient’s full name and corresponding pathology surgical/block number.
    3. Note: Samples fixed in Bouin’s reagent, acid decalcified, or processed with other acidic reagents are not suitable for molecular testing.
  5. Avoid arrival of the specimen on Fridays, weekends and statutory holidays.
  6. Shipping Address:
    Cancer Genetics Lab, Room # 3305

    British Columbia Cancer Agency
    600 West 10th Avenue
    Vancouver BC V5Z 4E6

Special Requirements

MPN (Myeloproliferative neoplasm) (JAK2 V617F) Peripheral Blood (2x6mL EDTA)
CML (Chronic myelogenous leukemia)
CML Diagnosis 4 mL Sodium Heparin Peripheral Blood to regional Cytogenetics Lab
CML Baseline by Quantitative PCR (qPCR) Peripheral Blood (20 mL EDTA) or 5 tubes minimum for patients with low white blood cell count
Minimal Residual Disease (MRD) test by Quantitative-PCR (qPCR) Peripheral Blood (20 mL EDTA) or 5 tubes minimum for patients with low white blood cell count
APL (Acute promyelocytic leukemia)
with t(15;17)
Minimal Residual Disease (MRD)test by Quantitative-PCR (qPCR) Peripheral Blood (20 mL EDTA) or 5 tubes minimum for patients with a low white blood cell count
AML (Acute myeloid leukemia)
(FLT3 and/or NPM1)
Diagnostic Bone Marrow sample as a MAA pellet, or Diagnostic Bone Marrow in EDTA
(cKIT D816V)
Peripheral Blood (2x6mL EDTA)
Lymphoma B/T Clonality
  • Bone Marrow (1mL EDTA) or Peripheral Blood (2x6mL EDTA)
  • Fresh Biopsy Kept Frozen on Dry Ice; Ship ASAP
  • Paraffin tissue, minimum 6×20 µm scrolls
Chimerism Pre-transplant: Peripheral Blood (2×6 mL EDTA) or DNA from both Donor and Recipient
Chimerism Post-transplant: Send 20 mL Sodium Heparin Peripheral Bloodto:

Stem Cell Assay/Terry Fox Laboratory
675 West 10th Ave.
Vancouver, BC V5Z1L3
ODG (Oligodendrogliomas)
1p/19q FISH
Tumour Paraffin Block (or 10×20µm scrolls)

Hereditary Cancer Testing

Patient must be referred to the Hereditary Cancer Program prior to testing.