HCDP Manchester

Lymphoproliferative disorders (LPD)

PATHWAY OPTIONS
There are a number of choices. Please ensure you select the correct pathway for your sample. Please give as much clinical detail as possible for all samples.

Pathway 12A: Lymphoproliferative disorder basic investigation (blood)

This pathway is advised used for the preliminary examination of lymphocytosis in blood where there may be a lymphoproliferative disorder present. Following flow cytometry further recommendations will be given if applicable.
The following tests will be performed:

  • Morphology
  • Flow cytometry

Pathway 12B: Lymphoproliferative disorder extended set (blood)

Use where further characterisation is needed to make the diagnosis in more complex cases – flow and morphology may be omitted if they have already been performed.
The following tests will be performed:

  • Morphology
  • Flow cytometry
  • FISH/cytogenetics (hold)
  • Molecular: DNA (analyse lymphoid panel if indicated)

Pathway 12C: CLL Additional prognostic options (blood or marrow)

Use this to stratify patients and guide treatment options in CLL.
The following tests will be performed:

  • FISH (CLL pre-treatment)
  • CLL Lymphoid panel inc TP53
  • IgVH hypermutation

Pathway 12D: Lymphoma or lymphoproliferative disorder (marrow)

Use this for complex or difficult cases, or where an assessment of infiltration is required. Select tests as appropriate to case. Note that cytogenetic and FISH samples will be analysed if appropriate.
The following tests will be performed:

  • Morphology
  • Flow cytometry
  • Trephine
  • Cytogenetics/FISH (hold)
  • Molecular (DNA hold analyse panel if indicated)

Pathway 12E: B-cell lymphoma follow up (marrow)

Use this for known B cell lymphoma samples requiring follow up.
The following tests will be performed:

  • Morphology
  • Flow cytometry
  • Trephine
  • Cytogenetics/FISH (hold)
  • Molecular (DNA hold analyse panel if indicated)

Pathway 12F: T/NK cell lymphoma follow up (marrow)

Use this pathway for known T/NK lymphoma patients requiring follow up evaluation.
The following tests will be performed:

  • Morphology
  • Flow cytometry
  • Trephine
  • Cytogenetics/FISH (hold)
  • Molecular (DNA hold analyse panel if indicated)

Pathway 12G: B cell lymphoma follow up (blood)

Use this pathway for known B cell lymphoma patients requiring follow up evaluation.
The following tests will be performed:

  • Morphology
  • Flow cytometry

Pathway 12H: T/NK cell lymphoma follow up (blood)

Use this pathway for known T cell lymphoma patients requiring follow up evaluation.
The following tests will be performed:

  • Morphology
  • Flow cytometry

Pathway 12J: BTK Resistance studies (blood)

Use this pathway to assess a patient for resistance to BTK therapy
The following tests will be performed:

  • BTK resistance studies