Multicentre verification of haematology laboratory blood collection tubes during a global blood collection tube shortage.

INTRODUCTION: Verification of blood collection tubes is essential for clinical laboratories. The aim of this study was to assess performance of candidate tubes from four alternative suppliers for routine diagnostic haematology testing during an impending global shortage of blood collection tubes. METHODS: A multicentre verification study was performed in Cape Town, South Africa. Blood from 300 healthy volunteers was collected into K2 EDTA and sodium citrate tubes of BD Vacutainer® comparator tubes and one of four candidate tubes (Vacucare, Vacuette®, V-TUBE™ and Vacutest®). A technical verification was performed, which included tube physical properties and safety. Routine haematology testing was performed for clinical verification. RESULTS: Vacucare tubes did not have a fill-line indicator, Vacuette® tubes had external blood contamination on the caps post-venesection and Vacutest® tubes had hard rubber stoppers. K2 EDTA tubes of Vacuette®, Vacucare and Vacutest® performed similarly to the comparator. Unacceptable constant bias was seen for PT in Vacucare (95% CI -2.38 to -0.10), Vacutest® (95% CI -1.91 to -0.49) and Vacuette® (95% CI 0.10-1.84) tubes and for aPTT in Vacuette® (95% CI 0.22-2.00) and V-TUBE™ (95% CI -2.88 to -0.44). Unacceptable %bias was seen for aPTT in Vacucare (95% CI 2.78-4.59) and Vacutest® tubes (95% CI 2.53-3.82; desirable ±2.30), and in V-TUBE™ for mean cell volume (95% CI 1.15-1.47, desirable ±0.95%) and mean cell haemoglobin concentration (95% CI -1.65 to -0.93, desirable ±0.43%). CONCLUSION: Blood collection tubes introduce variability to routine haematology results. We recommend that laboratories use one brand of tube. Verification of new candidate tubes should be performed to ensure consistency and reliable reporting of results.

Incidence of haematological malignancies, Eastern Cape Province; South Africa, 2004-2013.

BACKGROUND: The incidence of haematological malignancies in Africa's rapidly urbanising populations is insufficiently explored. Reliable population-based cancer statistics, however, continues to be a scarce resource in Africa and tends to be urban biased with limited rural coverage. In addition, many haematological malignancies are regarded as rare cancers, a sub-group that often affects the young disproportionately and require advanced diagnostic services and facilities able to deliver costly sophisticated treatments. This study provides a first attempt to estimate the incidence of haematological malignancies among the Eastern Cape Province population of South Africa. METHOD: Multiple public- and private sector data archives and resources were utilised to optimise the identification of incident cases, including clinical records; bone marrow; cytology; histology; flow cytometry and cytogenetic records. Crude incidence, age-and gender-standardised rates are presented and comparison made with existing national data and select data from other economically developed countries and global institutions. RESULTS: A total of 3603 incident cases were identified between 2004 and 2013. Mature lymphoid malignancies accounted for approximately 60% (n = 2153), myeloma/plasma cell neoplasms 13% (n = 465), acute leukaemia 17% (n = 596), chronic myeloid leukaemia 4% (n = 155) and other myeloproliferative neoplasms 6% (n = 234) when stratified according to conventional groups. Most subtypes increase with age, with male excess. CONCLUSION: Haematological malignancies in the Eastern Cape Province show disparities in gender and pathology-specific incidence patterns. The present study suggest that haematological malignancies are not uncommon in this region and the incidence rate of at least one rare subtype, APL, is comparable with some European populations.