Cancer Molecular Diagnostics Laboratory

The CMD laboratory provides an extensive repertoire of specialised molecular analyses.  Laboratory tests are organised into the following sections:

• Molecular analysis of leukaemia
• Chimaerism analysis post allogenic stem cell transplantation
• Provenance analysis
• Molecular analysis of lymphoproliferative disorders / carcinomas /sarcomas

The department is accredited by Clinical Patholgoy Accreditation (UK) Ltd.  The laboratory participates in the following external quality assurance programs:

• UK NEQAS Molecular Diagnostics of Haematological Malignancies
• PCR Clonality QC Scheme for evaluation of Lymphoproliferative disorders.

Research and development of new diagnostic targets and molecular techniques is an essential component of CMD.  Research activities are focused on areas of investigation which complement and enhance the services offered.

Sample Requirements

CMD request forms must accompany all samples sent for analysis

Peripheral Blood/Bone Marrow

DNA Based assays

Although certain molecular tests can be performed on very small amounts of material our preferred sample is 9 mL of peripheral blood (PB) in EDTA, or 1-3 mL of bone marrow (BM) in RPMI (1:3) dilution.  For chimaerism subset analysis, samples must arrive in the CMD laboratory before 11am and prior notification is required.

RNA based assays

Samples requiring RNA analysis should reach the CMD Laboratory within 24hours of collection and before 3.30 pm on Fridays to facilitate same dayprocessing. If any delay is anticipated, samples should be stored at 4ºC.For real time quantitative PCR (RQ-PCR) of BCR-ABL in patients receiving tyrosine    kinase inhibitor therapy (e.g. Imatinib Mesylate), peripheral blood (PB) samples are preferable for analysis.

(ii) Fresh Tissue

St. James’s Hospital internal samples - Lymph node biopsies and other tissue specimens should be sent as fresh unfixed tissue wrapped in saline-dampened gauze. Very small biopsies (i.e. needle biopsies) should be placed in sterile saline. Please call the CMD Laboratory (Tel: 01 410 3576/3575) to arrange immediate collection from theatre. After 5 pm, samples should be placed in formalin and sent to the histology laboratory.

Samples from external hospitals - Lymph node biopsies and other tissue specimens should be sent to the CMD laboratory as fresh unfixed tissue in saline-dampened gauze on ice, within 24 hrs of the sample being taken.

(iii) Fixed Tissue

St. James’s Hospital internal samples - Formalin-fixed paraffin embedded tissue should be sent accompanied by a CMD request form. Samples fixed in Bouin’s reagent are not suitable for analysis.

Samples from external hospitals - Formalin-fixed paraffin embedded tissue may be sent to the CMD laboratory if fresh tissue is unavailable. Samples fixed in Bouin’s reagent are not suitable for analysis.If pathological review is also required, please contact the relevant histopathologist.

Lymphoma samples  

Prof. D.S. O’Briain (Tel: 01-4162997) / Dr. Barbara Dunne  (Tel: 01-4162902)

Skin samples:  Dr. Máirín McMenamin  (Tel: 01-4162994)

Special requirements for Lymphoproliferative Analysis - Please enclose the following with the sample - Immunoglobulin/T cell receptor gene rearrangements from PB/BM

• Immunophenotyping report· Stained morphology slide
• Full patient clinical historyImmunoglobulin/T cell receptor gene rearrangements from fresh tissue/paraffin embedded tissue
• 2 H+E slides of the relevant material
• Accompanying histology reports
• Full patient clinical historyFor t(14;18) BCL2-JH and t(11;14) BCL1-JH analysis please send the original formalin fixed paraffin embedded material of the primary involved site together with the BM sample