Samples to promote research

Biobank samples (blood and bone marrow samples, skin biopsies) are collected primarily from patients with hematological malignancies. Samples shall only be collected from patients who have consented to it.

Samples are collected on weekdays only. A notification of sample collection (automatic email message) must be sent by 3:00 pm. However, on Fridays the notification needs to be sent by 2:00 pm. Regarding late deliveries, please inform the Blood Service in advance (tel. 044 434 4331) of any sample with an estimated arrival time after 4:00 pm.

The following includes general instructions for collecting samples from adult patients. For sample collection from children, please see separate instructions and hospital-specific instructions.

Instructions:

1. The Pt-Hembio test battery is included in the initial tests of patients with hematological disorders. The Pt-Hembio test battery includes the following subtests: B-Hembio (blood samples), Bm-Hembio (bone marrow sample) and Ts-Hembio (skin biopsy specimen). The Pt-Hembio test battery is included in the laboratory test batteries “MLeukemian_alkukokeet” (acute leukemia) and “MKMLalkuus” (CML, chronic myelocytic leukemia). The secretary will order these tests together with the usual tests.

2. When the patient arrives to the day hospital/hospital ward to give a diagnostic bone marrow sample, the nurse assisting with the operation hands the patient a FHRB Biobank information form.

3. The operating physician or a nurse introduces the study and asks for the patient’s consent to be included in the study. Any necessary pre-medications shall not be administered until after the patient has been informed about the study and they have been asked to participate in the study. Should the operation be carried out by a physician specialising in internal medicine, the chief physician or specialist in charge is responsible for introducing the study. The brochure and the signed consent form are sent attached to the referral to bone marrow tests to the Blood Service.

4. The operating physician enters the patient into the Finnish Hematology Registry, and selects Lisää biopankkinäyte (Add biobank sample) from the Toiminnot (Actions) sidebar (on the left side of the screen). Next, the physician selects the date for testing, the status of the disease at the time of sampling and the hospital. The software automatically generates an email message regarding the collected sample and sends it to the Finnish Red Cross Blood Service. If you are unable to add a patient record into the Finnish Hematology Registry, please contact Anna Gesterberg or Mika Kontro. If sending an email notification fails, inform the FHRB Biobank, tel. 044 434 4331, of the collected samples.

5. To add information about the FHRB examination to the patient’s records, click “Uusi tutkimus” (New Examination) on the side bar and then “SHY FHRB” from the drop-down list.

6. The physician fills in a referral to tests by using ”Lähete Hematologisen biopankin näytteille”. Print two copies of the referral - one is sent with the bone marrow samples, the other is handed over to the patient to take to the laboratory. Make sure the referral includes a specific date and time for the appointment, and the patient’s FHRB number.

7. Skin biopsy (to determine congenital genome) is performed using a specifically designed punch with a 4 mm diameter. A combination of lidocaine and adrenaline is used as an analgesic. Only one skin biopsy is performed on a patient. Skin biopsies are performed on the skin in the area of iliac crest biopsy. It is recommended that bone marrow biopsies are performed using another site. The biopsy specimens are then dropped into one preservative-free tube filled with saline solution (cerebrospinal fluid tube). Skin biopsies are performed during the first sampling only. Follow sterile procedures when performing biopsies. Instructions (link to Skin Biopsy PDF).

8. The planned diagnostic bone marrow specimens are collected first. Specimens used for research purposes are only collected after the necessary diagnostic samples have been collected. For research purposes, as much bone marrow is aspirated as possible, but no more than 30 mL. Bone marrow samples are collected into 9 mL EDTA tubes each holding max 5 mL. If no bone marrow can be collected, it is recommended to draw blood samples. If the patient is in remission, the maximum aspirated volume of bone marrow is 10 mL.

9. A medical laboratory technologist takes the blood samples either in the laboratory or at the hospital ward. Required samples include the following: 9 mL blood in a serum tube (1 tube), 9 mL blood in a heparin tube (1 tube), 9 mL blood in an EDTA tube (2 tubes).

10. The collected specimens are taken to sample sorting/outgoing samples, and packed for transportation.

11. After sorting, the specimens are transported by taxi to the Blood Service (in Kivihaka). All specimens are transported refrigerated (+2˚C...14˚C) in the same package.

12. The treating physician or a nurse records “SHR” on the patient’s diagnosis as soon as it is ready.

Other information:

Biohazard:
• Do not collect specimens or samples for biobanking, if the patient is known to carry a blood-borne infectious disease (e.g. HIV, or B or C hepatitis)
• If the patient is later diagnosed with an infectious disease, inform Anne Gesterberg about this.

For more information on sample collection, please contact Anne Gesterberg (tel. 040 7706359).