Beryllium by Lymphocyte Transformation, BAL (Sendout)

Useful For: Diagnosing beryllium sensitization using bronchoalveolar lavage fluid. The BeLPT is sensitive and specific for beryllium-related health effects. Exposure to beryllium can be toxic and lead to adverse health effects, including beryllium sensitization (BeS) and chronic beryllium disease (CBD). Individuals sensitized to beryllium are asymptomatic; however, BeS greatly increases the risk of developing CBD.

Ordering Requirements:

• Collections must be pre-scheduled with DLMP Hematology due to special processing requirements. To arrange for testing, contact the appropriate Hematology laboratory location below based on collection site.
  
  • UW-Montlake Hematology: 206-598-6234
  • HMC Hematology: 206-744-3451
  • Test is not available at UW-NW. Arrange for collection at UW-MT or HMC.
• Cell Count & Differential, BAL [BALCTG] should be ordered concurrently and results forwarded to NJH with the order.

Collection Note: Limited specimen stability. Samples must be collected Monday through Thursday only, processed by Hematology lab same-day, and received at NJH within 24 hours of collection. Failure to follow collection guidelines may result in test cancellations.

Collection Timing:

• Specimen must be collected Monday - Thursday only between 10am - 12pm.
  
• This test must be pre-scheduled with the Hematology Lab at UW-MT (206-598-6234) or HMC (206-744-3451) to ensure proper processing.
  

Specimen Requirements: Collect 240 mL BRONCHIAL WASH collected in a sterile container.

Post-Collection: Expedite transport to the laboratory. Specimen must be received in lab at UW or HMC by 12:30pm for processing and same-day shipment to the referral lab. Specimen must be received by referral lab (National Jewish) within 24 hours of collection.

SPS: Deliver ambient unspun BAL sample to Hematology as soon as possible. Notify Sendouts staff of a sample requiring same-day shipment. Hematology will process and return the sample to Sendouts.

Login: SEND1-;RM TEMP

• RSNDT1: NJH
• RSTYP1: BAL
• RTSRQ1: ;LTT for Beryllium (NJH Test BEBAL)

Hematology:

• After cell count has been performed, centrifuge the lavage specimen (approximately 1200 rpm x 10 minutes).
• Remove supernatant. Re-suspend cells in complete medium. This consists of: RPMI 1640 (or similar tissue culture medium) with gentamicin sulfate or pen/strep (0.5% by volume) and serum 10% by volume (can use pooled AB positive serum or patient's own serum).
• Final concentration of cells in media should be approximately 5-10 million cells per mL. Place in a plastic centrifuge tube and seal.
• Immediately deliver processed sample to UW-MT or HMC Sendouts for same-day shipment to NJH ADx Labs.

Sendouts:

• Complete a NJH Beryllium requisition and order NJH Test: BEBAL.
• Enclose a printed copy of BAL cell count and differential results with the sample.
• Ship samples at ambient temperature the same day of collection using FedEx "First Overnight" priority. Samples must be received in the laboratory within 24 hours of collection.

Stability: Ambient (required): 30 hours; Refrigerated: Unacceptable; Frozen: Unacceptable.

Unacceptable Conditions: Specimens received more than 30 hours old, frozen specimens, specimens in lithium heparin, specimens in tubes with gel such as SSTs and PSTs.