Pre-Treatment Investigations

The investigations listed here are appropriate for any new patient with AA that is scheduled to receive intensive treatment.

The extent of any investigations to be carried out on other patients with AA and related conditions will be decided by the Consultant.


About this Canterbury DHB document (4924):
Document Owner:	Not assigned (see Who's Who)
Last Reviewed:	November 2019
Next Review:	November 2022
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Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer The Haematology Department Protocols and Guidelines (the Red Book) are intended as a guide for registered health professionals to communicate guidelines and share best practices with supporting health professionals within New Zealand district health boards. They are not intended to be provided to or used as a reference for patients or non-registered health professionals. All health professionals must exercise their own clinical judgement and use pertinent clinical data when treating patients. The authors and editors of this publication have checked with sources believed to be reliable in their effort to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical science, neither the authors, editors, publisher, nor any other party who has been involved in preparing or publishing this work warrants that the information contained in it is accurate or complete in every respect. They therefore have no liability (whether in tort (including negligence) or otherwise) for any loss or damage arising out of any reliance on this information. This publication has been compiled by the staff and contractors of Canterbury District Health Board (CDHB) and as such CDHB has copyright for this book. Amendments must be authorised in accordance with the documented process. No release of part of, or all of, this publication to any other party or organisation is permissible without the prior approval of the designated document owner.
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	Test Required	Volume of Blood/ Container
Blood Tests	CBCD + F, retics, ESR, DIC profile, Serum B12 and red cell folate.	3 x 5 mL EDTA (mauve top), 1 x 5 mL citrate, 1 x 5 mL plain.
	ONCO hyperlink profile, CRP, Ferritin, SPE, Ig levels, iron studies, thyroid function.	1 x 5 mL heparin, 1 x 5 mL plain.
	Blood group & red cell antibodies.	1 x 7.5 mL EDTA (pink top).
	Viral serology-HbsAg, HCV, Herpes simplex/zoster, CMV, EBV, Toxo, TPHA, HIV test, patient permission required.	1 x 5 mL plain (request long term storage).
	HLA Typing.	Contact SCT Coordinator. 2 x 10 mL CPDA (yellow top), 1 x 10 mL plain, 1 x 6 mL EDTA
	Cell surface marker analysis on blood for the GPI-linked proteins CD55 and 59 (for PNH).	Arrange with surface marker lab (ext 80917).
	Cytogenetics on peripheral blood if Fanconi anaemia suspected.	Blood 10 mL in heparin (may require more if WBC count very low).
Bone Marrow	Bone marrow aspirate and trephine. + Cytogenetics if MDS suspected.	Arrange with Haematology Registrar.
Swabs	Microbiology-swabs from nostrils, throat, swabs of any infected lesions.	Label forms for bacterial and fungal cultures “New Aplastic”.
Radiology	ECG, Chest X-ray.	All patients.
Other	MSU, sputum, stool.	If clinically indicated.
	Blood cultures.	If clinically indicated.
Referrals	Fertility Centre, dental assessment, Hickman or PICC line insertion, ? irradiated blood, ? CMV negative blood.	Doctors to organise.
	OT, Physio, Social Worker, Dietitian, Psychologist Assessment.	Nurses to organise.