TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: HAEVP    
Hemolytic Anemia Evaluation

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

This is a consultative evaluation in which the case will be evaluated and appropriate tests performed, at an additional charge, and the results interpreted. If a peripheral blood smear is provided, the morphologic features will be incorporated into the interpretation. If a Hemolytic Anemia Patient Information sheet (T705) is received with the sample, the reported clinical features or clinical impression will be incorporated into the interpretation.

 

The most common RBC enzymes (G6PD,pyruvate kinase, glucose phosphate isomerase, and hexokinase) will always be performed. If these are normal, the second-tier enzymes will be performed (provided sufficient sample volume is available). If second-tier enzymes are desired, even if the first-tier testing is abnormal, fill out the Hemolytic Anemia Patient Information sheet (T705) and indicate this desire. Cation exchange HPLC, capillary electrophoresis, and hemoglobin stability studies will always be performed. Reflex testing required to identify a hemoglobin abnormality can be added as the case requires. Osmotic fragility and eosin-5-maleimide (EMA) binding (band 3) flow cytometry will be performed on all cases. A normal shipping control for osmotic fragility (OF) is necessary to exclude false-positive results due to preanalytical artifact.

 

OF and EMA binding testing will be canceled if no shipping control is received or if the shipping control is abnormal.

 

HAEVA / Hemolytic Anemia Summary Interpretation, an additional consultative interpretation that summarizes all testing, will be provided after test completion to incorporate subsequent results into an overall evaluation if 1 or more of the following molecular tests are reflexed on the Hemolytic Anemia Evaluation:

-ATHAL / Alpha-Globin Gene Analysis

-WASQR / Alpha-Globin Gene Sequencing, Blood

-WBSQR / Beta-Globin Gene Sequencing, Blood

-WBDDR / Beta-Globin Cluster Locus Deletion/Duplication, Blood

-WGSQR / Gamma-Globin Full Gene Sequencing

 

Note: RBCE / Reflexed RBC Enzymes, Blood (second-tier enzymes) includes: adenylate kinase, phosphofructokinase, phosphoglycerate kinase, triosephosphate isomerase, and pyrimidine 5' nucleotidase.

 

See Benign Hematology Evaluation Comparison in Special Instructions.

Specimen Type Describes the specimen type validated for testing

Control
Whole Blood ACD-B
Whole Blood EDTA
Whole Blood Slide

Advisory Information

Preliminary screening tests, such as complete blood count with peripheral smear and direct Coombs test with a negative result, should be run before ordering this evaluation.

 

Cold agglutinin disorders and autoimmune disorders should be excluded prior to testing. This evaluation is not suitable for acquired causes of hemolysis.

Shipping Instructions

Specimens must arrive within 72 hours of draw.

Necessary Information

Include recent transfusion information.

 

Include most recent CBC results.

Specimen Required Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Two whole blood EDTA specimens, 2 whole blood ACD specimens, an EDTA control specimen, and 2 well-made peripheral blood smears (Wright stained or fixed in absolute methanol) are required for testing.

 

Patient:

Specimen Type: Blood

Container/Tube: Lavender top (EDTA) and yellow top (ACD)

Specimen Volume:

EDTA: Two 4-mL vials

ACD: Two 6-mL vials

Collection Instructions:

1. Immediately refrigerate specimens after draw.

2. Send specimens in original tubes. Do not aliquot.

3. Prepare smears.

4. Rubber band patient specimen and control vial together.

 

Patient:

Specimen Type: Slides

Container/Tube: Blood smears

Specimen Volume: 2 well-made peripheral blood smears

Collection Instructions: Collect 2 well-made peripheral blood smears (Wright stained or fixed in absolute methanol).

 

Shipping Normal Control:

Specimen Type: Whole blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: 4 mL

Collection Instructions:

1. Draw a control specimen from a normal (healthy), unrelated, nonsmoking person at the same time as the patient.

2. Label clearly on outermost label normal control.

3. Immediately refrigerate specimen after draw.

4. Send specimen in original tube. Do not aliquot.

5. Rubber band patient specimen and control vial together.

Special Instructions Library of PDFs including pertinent information and forms related to the test

Forms

1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available in Special Instructions:

-Informed Consent for Genetic Testing (T576)

-Informed Consent for Genetic Testing-Spanish (T826)

2. Metabolic Hematology Patient Information (T810) in Special Instructions. Please fill out for a more complete evaluation by the signing Hematopathologist.

3. If not ordering electronically, complete, print, and send a Benign Hematology Test Request (T755) with the specimen.

Specimen Minimum Volume Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

EDTA Blood: 3 mL
ACD Blood: 5 mL

Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject

Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen TypeTemperatureTimeSpecial Container
ControlRefrigerated72 hoursPURPLE OR PINK TOP/EDTA
Whole Blood ACD-BRefrigerated72 hours
Whole Blood EDTARefrigerated72 hours
Whole Blood SlideRefrigeratedCARTRIDGE