Factor VIII Inversion DNA (Sendout)

Test Information: In severe hemophilia A, a common recurrent intron 22 gene inversion accounts for ~45% of the cases. A recurrent intron 1 inversion accounts for ~5% of the cases. These two sites are the first to be screened for severe hemophilia A patients.

If mutation is not identified, further screening can be performed by Hemophilia A DNA Evaluation (Sendout) [RDHEMA]. Request "reflex to DNA Hemophilia A Mutation (Test 3250-02)" on the Bloodworks requisition or via Epic order question.

Ordering Requirements:

• Orders from Washington Center for Bleeding Disorders (SEAWBD), FHCC Hematology, and UW Medicine Prenatal Genetics are pre-approved. Orders from other locations require Laboratory Medicine Resident approval.
• For orders not submitted via Epic or ISEAWBD interface, providers must complete a Bloodworks NW Eastlake Genomics Lab Requisition.

Whole Blood: 10 mL LAVENDER TOP EDTA tube

Cultured Amniocytes: Two T-25 flasks of cells cultured to confluency.

• Amniotic fluid is not accepted.
• An EDTA whole blood sample from the mother of the fetus must accompany cultured amniocyte orders.

Extracted DNA: >10 ug extracted DNA at a concentration of >25ng/ul

Collection Timing:

• Collect any time Monday through Thursday.
• Samples collected on a Friday must be timed appropriately to ensure delivery at Bloodworks Eastlake Lab by the 1 p.m. cutoff.

Samples sent on Fridays must be received at Bloodworks Northwest Genomics Lab by 1 p.m.

Outside Laboratories:

• Store and transport whole blood at ambient temperature.
• Expedite transport; samples must be received by Bloodworks NW within 72 hours of collection and before 1 p.m. on Fridays. Allow for one day of transport from UW-MT to Bloodworks Northwest.
  • Unless the cells are cultured at UW-MT Cytogenetics and Genomics Lab, clients should arrange to send cultured amniocyte samples directly to Bloodworks NW due to the short stability window.
• Submit a completed Bloodworks Northwest Eastlake Genomics Requisition along with the DLMP Requisition.* Leave the billing section blank to be completed by Sendouts staff.
  • *Use client-specific requisition when available. To obtain a client-specific requisition, contact Client Support Services via email at: commserv@uw.edu.
• WA Center for Bleeding Disorders only: A separate Bloodworks NW requisition is not required for orders submitted via interface.

Stability (Whole Blood): Ambient (preferred): 72 hours; Refrigerated: 72 hours; Frozen: -20°C or -70/80°C. Avoid thawing/re-freezing.

• Frozen EDTA tube(s) are accepted if samples are frozen the day of the blood draw, never thawed, and are shipped and received on dry ice. Contact Eastlake Bleeding Disorders at (206) 568-2184 with questions about sample acceptability.

Result-at-Entry:

• RDF8IS (Factor VIII Inversion DNA Sample Type): <Specimen type will file automatically for orders placed in Epic. For others, enter the appropriate specimen type code.>

Processing:

• Maintain whole blood and cultured amniocyte samples at ambient temperature.
• Whole blood received frozen should be stored frozen.
• If sample is collected on a Friday, notify Sendouts immediately upon sample receipt to ensure delivery to Bloodworks NW by the 1 p.m. cutoff.

Sendouts (UW-MT/HMC) and FHCC SPS:

• Bloodworks NW Test: 3250-05
• Submit a copy of the ISEAWBD eREQ or Epic requisition with the sample (ensure that all pages are printed to accommodate the order questions). For orders not placed in Epic or via the ISEAWBD interface, a separate Bloodworks Northwest Eastlake Genomics requisition is required.
• Package sample(s) with the associated requisition in a biohazard bag (one patient per bag). Orders received with multiple patient samples/requisitions in the same biozard bag will be rejected by Bloodworks NW.
• Blood:
  • Send blood orders as received with the UW DLMP or Delivery Express courier directly to the Bloodworks NW Eastlake location.
  • Transport whole blood at ambient temperature. Whole blood received frozen should be stored frozen and transported on dry ice.
  • Samples may be sent Monday through Friday only. If sent on a Friday, samples must be in lab at the Eastlake location by 1 p.m.
  • Ambient or refrigerated whole blood samples must arrive at Bloodworks within 72 hours of collection.

• Cultured amniocytes:

  • Send cultured amniocytes same-day to the Bloodworks Central Genomics Lab (921 Terry Ave, Seattle WA 98104).
  • Cultured amniocytes must arrive at Central Genomics within 48 hours of collection and by 1 p.m. on Fridays.

Stability (Whole Blood): Ambient (preferred): 72 hours; Refrigerated: 72 hours; Frozen: -20°C or -70/80°C. Avoid thawing/re-freezing.

• Frozen EDTA tube(s) are accepted if samples are frozen the day of the blood draw, never thawed, and are shipped and received on dry ice. Contact Eastlake Bleeding Disorders at (206) 568-2184 with questions about sample acceptability.

Stability (Cultured Amniocytes): Samples must arrive within 48 hours to the Central Genomics location (amniocytes should not be sent to the Eastlake laboratory).

Contact the Bloodworks NW Eastlake Genomics Lab at 206-568-2184 for sample acceptability questions prior to cancelling orders outside of the stated stability window.