SWGLH Requesting a genomic test for haematological malignancy

The South West Genomic Laboratory Hub (SWGLH) offers the following genomic tests for patients with haematological malignancy:

 

  1. Karyotyping, FISH, direct mutation, molecular monitoring and gene panel tests for haematological malignancy affecting the blood and bone marrow. The drop down list choices on this page will take you through the requesting process.
  1. For FISH, direct mutation and gene panel tests for lymphoma and related disorders not affecting the blood or bone marrow: Please see requesting a genomic test for solid tumours
  1. Whole genome sequencing for any haematological malignancy in the children and young adults and in all patients with acute leukaemia: Please see requesting a whole genome sequencing test

Step 1 Check patient eligibility

Eligible haematological malignancies and the available tests are shown in the National Genomic Test Directory for Cancer (NGTD).

  • The NGTD indicates several possible alternative tests for some indications. Regional policy about the best test for each indication is being devised by the SWGLH and the haematological malignancy Cancer Alliance Advisory Groups (CAG)

 

Step 2 Collect the sample(s)

Where possible, samples for diagnostic or monitoring genomic tests should be collected alongside other samples for the regional Specialist Integrated Haematological Malignancy Service (SIHMDS).

  • Bone marrow aspirate is the preferred substrate for Haematological malignancy testing.
  • Blood or other tissue may be suitable where sufficient (>20%) involvement is identified e.g. for acute leukaemia with a high circulating blast count. Pleural fluid or other tissue with a malignant infiltrate may also be suitable but should be discussed with the SWGLH, contact information below
  • 1-2ml of bone marrow aspirate or 5-10ml of blood collected into EDTA is required for direct mutation, molecular monitoring or gene panel tests
  • 1-2ml of bone marrow aspirate or 5-10ml of blood collected into lithium heparin or heparinised media is required for karyotype and FISH

Step 3 Complete the request form

 All samples for genomic testing for haematological malignancy should be accompanied by a fully completed 

Step 4 Transportation of sample and request form to the SWGLH

You will then need to transport samples and request form to the SWGLH

  • To maintain clinically useful test turnaround times, samples should be transported urgently to the SWGLH for processing and testing.
  • Samples will usually be sent internally to the local pathology specimen reception and, then onwards, to the SWGLH at the Bristol Genetics laboratory site, using the rapid transport routes that have been established from all SW Trusts.
  • Refer to the Sample requirement and Test Pages for this information

 

Step 5 What are the turnaround times for the test?

Turnaround times (TATs) for genomic tests are continually refined through the ongoing review of testing standards by NHSE, the SWGLH and CAG working groups.

  • As a guide, example current TATs are:
    • PML-RARA <24 hours
    • BCR-ABL1 PCR, ALL FISH <3 days
    • Urgent karyotype/FISH <7 days
    • Urgent gene panel, direct mutation tests, CML monitoring <14 days
    • Routine karyotype, FISH, panel <21 days

SWGLH Haematological malignancy Clinical Scientist Team Contact Info

email at nbn-tr.haematooncology@nhs.net or telephone at 0117 4146168

SWGLH Haematological malignancy link to SiHMDS

 Further information can be found on the Integrated Haematological Malignancy Diagnostics service site and for particular reference the back of the Bristol Haemato-Oncology Diagnostic Request Form:

SWGLH Haematological malignancy - Clinical Guide

Download a copy of the: 

 

Page last updated 30th March 2022