Bone marrow specimen transport kit (liquid Heparin)

• For sites that provide their own liquid heparin to procure the 2nd aspirate

Bone Marrow Aspirate

1. Heparinized aspirate (first aspirate)
   1. Collect 2-4 mLs of heparinzed aspirate.
   2. This syringe will be set aside and not handed off immediately.
   3. Transfer into 8mL Polystyrene Round Bottom Falcon Tube provided in kit.
2. EDTA aspirate (second aspirate)
   1. A minimum of 5mL of EDTA aspirate is required.
   2. Extra aspirate will be placed in EDTA tubes after processing. No portion should be discarded.
3. Heparinized aspirate (third aspirate)
   1. Collect 5-10 mLs of heparinzed aspirate.
   2. Transfer to 15 mL sterile Falcon tube provided in kit.

Note: Sites not using liquid heparin should transfer heparinzed aspirates to the 2 sodium heparin tubes provided in the kit.

FIRST ASPIRATE (Smears)

• Smears are prepared on a frosted or super-frosted slide
• The slides must be labeled on the frosted end using a pencil or a slide/cassette labeling marker to include:
• Patient’s full first and last name
• Date of birth
• Date of collection
• Slide type (direct, unit or TP)
• Left or right

1. Prepare 4 Direct smears

1. Smear made with technique used for making a blood smear

        2. Prepare 4 Unit smears

1. Locate unit within drop of aspirate on slide
   1. Notify procurer if units are not present
2. Soak up residual aspirate to isolate unit
3. Lie a second slide on top of unit and gently press down to crush unit
4. Pull slides apart in a parallel motion

SECOND ASPIRATE

1. If syringe is not heparinized, immediately dispense into (2) Sodium Heparin tubes supplied
2. If syringe is heparinized, transfer to (2) 8 mL polystyrene round bottom Falcon tubes for transport

CORE(S)

1. Prepare 4 touch prep slides
1. Gently press core biopsy to slide 5 - 6 times at close intervals over the bottom 1/3 of the slide
2. Roll core slightly with edge of slide every 2 - 3 touches to acquire imprints of entire core
3. Repeat steps a and b with core biopsy from opposite side if bilateral

     2. Place core biopsy(ies) in B-plus fixative container supplied in kit

a. Cores from different sides should not be put in the same container

     3. Label the container

a. If no patient label available, label container with patient complete legal first and last name and date of birth

b. Write “core”, side of biopsy (L or R), time the core was put into B-plus fixative and initials on label

Bone marrow specimen transport kit

Bone marrow specimen transport kit (Sodium Heparin)

• For sites that do not provide their own liquid heparin to procure the 2nd aspirate

• Bone Marrow requests must be accompanied with both forms:
  • Bone Marrow Specimen Notification Form 
    • Must be submitted in advance of the specimens
  • Bone Marrow Worksheet
    • Fill in the areas shaded in grey
• Complete Blood Count with Differential and Reticulocyte results are required
  • Include results with the request, or submit an EDTA whole blood (peripheral) sample with the bone marrow and testing will be performed at an additional charge

Ambient

Bone marrow study samples should be transported the day of collection

     Packaging and shipping requirements

1. Package the labeled, dried, unstained glass slides in plastic slide carriers provided in kit
2. Place slide carriers in biohazard specimen bag and all paperwork in the outer pouch
3. Place peripheral blood, EDTA aspirate and heparinized aspirate in 2nd biohazard specimen bag
4. Place B-plus fixative core container(s) in a 3rd biohazard specimen bag
1. B-plus fixative MUST be in bag separate from other specimens as B-plus fixative fumes will damage prepared slides and make them unusable
5. Package slides and specimens in the Courier Transport bag the kit supplies were sent in
1. If multiple bone marrows are being sent, send one (1) bone marrow per Courier Transport bag
6. Place a courier barcode label on the Courier Transport Bag and the matching label in your log book
7. Transport to Allina Health Laboratory with your next available courier at ambient temperatures
   1. Arrange for an unscheduled courier if necessary
8. Do not freeze any of these samples

• Improper label (unlabeled or mislabeled)
• Clotted specimen
• Improper anticoagulant or ratio
• Hemolysis
• Delay in transport
• Improper storage/transport temperature
• Slides broken beyond repair

Microscopic evaluation