Malignancy – haemato-oncology

Bone marrow samples

For samples received in the wrong tube, or clotted/haemolysed upon receipt, processing is usually attempted as the sample is not easily repeatable. However this may compromise the success or quality of the test.

 

Blood samples - leukaemia patients

For urgent referrals, if received in the wrong tube, or clotted/haemolysed, processing is usually attempted, however this may compromise the success or quality of the test. For a routine referral, the sample may be rejected and a repeat sample requested. Alternatively,  FISH  testing may be attempted on these samples.

Please note, samples from patients with suspected TB cannot be processed, please see  high risk samples .

Referrals may be at diagnosis, for routine monitoring, at disease progression or at relapse for:

• Acute Myeloid Leukaemia (AML)
• Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN)
• Acute Lymphoblastic Leukaemia (ALL)
• Chronic Myeloid Leukaemia (CML)
• Myelodysplastic Syndrome (MDS)
• Myeloproliferative Neoplasia (MPN)), including ET, PV and PMF
• Chronic Lymphocytic Leukaemia (CLL)
• Hypereosinophilic syndrome (HES)
• Juvenile Myelomonocytic leukaemia (JMML)
• Chronic Myelomonocytic leukaemia (CMML)
• Aplastic anaemia
• Myeloma*
• Bone marrow infiltration by cells from Tumour

Myeloma samples will be routinely processed for CD138 selection only. Samples are only suitable for cell selection if there are more than 10% plasma cells present.

For lymphoma samples, including Burkitts and DLBCL, please send FFPE slides for FISH analysis. Please see the  solid tumour  page for sample requirements.

Testing is determined by clinical indication; please ensure all relevant information is included on the referral form so that the correct processes and tests are initiated. Testing is carried out in line with the test directory published on  NHS England website  and may include karyotype, FISH or array analysis. Please see our  Haematology FISH probes  for FISH tests available. Please  contact the laboratory  to speak to a Clinical Scientist if further information is required.

The table below shows our target reporting times. See our current TAT data.

Target reporting times

Target Time	Clinical Scenarios
3 days	FISH for PML::RARA in new APML (typically 24 hours) BCR::ABL1 in new CML or new ALL CBFB and RUNX1::RUNX1T1 in new AML
7 days	Final report for karyotype and FISH in new AML and CML Final report for microarray and FISH in new ALL Karyotype/FISH for disease progression and relapse FISH for lymphoma
14 days	FISH for CLL Routine monitoring referrals
21 days	Karyotype for MDS, MPN FISH for myeloma

Samples may be processed more urgently upon clinical need. Please contact the laboratory to discuss individual requests.

Samples will be processed and archived if the reason for referral is non-specific or at clinical request. These samples can be re-activated by clinical request.

Lymphoma referrals will typically be archived pending information regarding bone marrow aspirate involvement but please note that FFPE tumour tissue is more reliable in these cases.

Fixed material from all bone marrow and leukaemic blood referrals is stored after reporting for 10 years for possible future testing. DNA is stored indefinitely.

Page last updated 08/08/2025. Please note that if printed, the information is only valid on the day of printing.