Re: Question regarding bone marrow samples

From: Maryalice Stetler-Stevenson (stetler@box-s.nih.gov)
Date: Thu Sep 07 2000 - 09:37:03 EST


We routinely use heparin for our bone marrow aspirates and it serves
us well. We provide a transport media with tons of heparin and
volume- thus we anticoagulae by heparin and dilution. To prepare the
transport media we takee 15 mL RPMI in a 50 mL conical tube and add
50,000 units of heparin in 5 mL PBS to final of 2,500 units/mL, in 20
mL. We instruct the clinician to rinse the syringe with sterile
heparin and leave some in before aspiration. Immediately
post-aspiration they should place the bone marrow  in transport
media, cap tightly and mix by inverting 5-6 times. We see the jelly
you describe in AML (which often clots against tremendous odds) and
occasionally in lymphoma cases, but this is rare. I think you didn't
have enough anticoagulant.

	Maryalice


>
>
>Hi
>
>I read your comments on ACD in the Purdue message board. I wonder if
>you can explain this.
>
>I work on blood and bone marrow specimens, usually with EDTA. Blood
>is no problem but bone marrow can really be awful. Occasionally,
>like today, a bone marrow sample that i got from antoher hospital
>looks like it has jelly- fied. it is not clotted. just STICKY as can
>be and pretty impossible to work with. Since i got the sample still
>in the syringe (with a cap on it) i strongly suspect the
>anticoagulant is heparin. because bone marrow is not an easy
>procedure i tried to salvage some cells. I usually q-prep or
>ammoniaum chloride, but this time only ficol saved a few but most of
>the cells were gone.
>
>questions:
>what anticoagulant do you prefer for bone marrow samples?
>have you come accross this phenomenon and can you explain it.
>is there anything i can do to salvage the sample.
>
>thanks for your time
>
>judith chezar
>Israel
>
>
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Maryalice Stetler-Stevenson
Director Flow Cytometry Unit
Laboratory of Pathology, NCI, NIH



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