Nate S

CLIA guidelines require QC to be performed every 8 hours, there is no way around this one.

No - if they have different CLIA numbers they are considered different labs and comparison is not required between labs. However, some believe it is good practice to perform correlations between sites, but not required.

So we decided to go with the comment: "Biotin (Vitamin B7) in high doses have been shown to potentially interfere with this test, by causing a clinically significant bias." I think this will give providers a reminder to check the patient's home meds - including supplements when they get a low/high result that doesn't match the patient's clinical picture.

Hi Everyone, Wanted to see how other labs are handling education of Biotin interference to physicians. I am looking at putting a canned comment on all tests that can be affected by high levels of Biotin ingestion - wanted to see if anyone has done this yet and what comment they are using. Thanks.

No, you can't validate anything to last longer than what the manufacturer states when it comes to stability of use. It would be considered using "expired" reagents by regulators and a citation could be written as such. I throw a lot of saline away as well, but it's better than worrying about getting cited for using expired reagents.

Have you contacted Sysmex about this? They would be your best bet in recommending what to use for their analyzer.

Yea, I was thinking flow cyto would be a good start to see if it's not something more serious. They don't look like lymphoma cells at all - they look like the typical reactive lymphocytes you would see on a peripheral smear.

Hi Everyone, This is a question for the Hematology experts out there. What is the clinical significance of someone that has chronic reactive absolute lymphocytosis with a normal WBC count? Do you think more testing to follow-up is required and if so what test(s)? I've done lots of research on this topic, but wanted to see what everyone's thoughts/ideas are regarding this topic.