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Larger sample required for BCR-ABL?


Has anyone else had an issue with the size of blood sample required for a BCR-ABL? It used to be a purple topped tube (7ml sample). After my last test in July it took ages to get the result, which was that there had not been enough sample - they now need 12ml. I went today to have another sample taken (at Countess of Chester) and the phlebotimist had not heard about any change. I got her to check and she came back 5 minutes later to tell me I was right and she now needed to fill 3 pink tubes (4ml each). If I hadn't stirred her up it would have been another wasted trip. The samples go from Chester to Liverpool for testing. Anyone else had a similar experience? 

Hi Alistair,

Yes i believe it should be 3 or 4 purple/pink tubes so from 12 to -15/16 ml in total .Some phlebotomists have a small  notebook with all the blood tests they are likely to encounter in alphabetical order so one might have to prompt them to look under PCR  or Bcr/Abl etc to find the right listing.

Another issue is that of spoilt samples-historically some of mine were sent for testing by snail mail so were out of date .It might help to politely ask how the sample will be sent by courier or other secure means.Having the sample taken earlier in the day might also help the logistics as well.

On has to remember that not many of us have CML which is still a rare disease so it might be useful to prompt the phlebotomist if one gleans that they are unsure.


Talking as someone who has managed accredited laboratories professionally in the past, while the phlebotomists try with their notebooks the management  systems should make it impossible for them not to know. The one who took my sample last week said she would send a message round the hospital phlebotomists WhatsApp group to let her colleagues know.  I should say this was in the haematology clinic, not the general hospital phlebotomy service.

Interesting - all of my PCR tests have been in a single lavender top (EDTA) Vacutainer. There is of course usually between 3 and 5 Vacutainer used each go, for different tests but the PCR test - marked “BCRN” has always just been a single one.


David, that's how mine have been for many years, but for some reason the centre in Liverpool now needs a larger sample, which has not been well communicated down the line to the hospitals and the phlebotomists who send them samples. Probably means there is a new test process and we will need to chase the to get a revised IS conversion factor.

Hi Alastair  ,thanks for this information,I am due at Clatterbridge Wirral soon and my blood goes to Liverpool so I will go armed with this information and hope they get my test done correctly ,Regards ,Denise.

I see different phlebotomists most times at my GP surgery and they take out the EDTA files and fill at least 2 sometimes 3 for the BCR ABL in the belief that the more the better. I am the only patient with CML and so they don't know what to take from me! I just say take as much as you like and no I have no idea what colour the top should be as they have changed so many times over the past 12 years. One suggested she was taking the same amount as a blood donor gives - but I'm sure that was an exaggeration (I am always looking in the other direction deliberately). Good thing I have no problem with blood flow but I do drink 3 pints of water before going. My 3 monthly appt last week I was asked what to send the blood to Bristol in!! No idea - all blood for CML now sent to Bristol instead of the Exeter Hospital. In the end it went recorded delivery insoide a poo (sorry, "human waste") box..... have to laugh.

At least they are brilliant at jabs.....



Hi, Alastair ,had my bloods done today and nobody knew about any changes in quantity of sample for BCR ABL.They rang thru to someone to check ,not sure if they actually rang Liverpool tho and the reply was no it's only one needed ,but they did take 3 just incase .So who knows .

At my local hospital I have alway had 5 ‘purple top’ vials taken for my BCR which get put into a separate bag to be sent to Kings. When Iv had my BCR taken at kings it’s also been 5 vials. It even specifically says it on the ‘special’ blood form I have to have for it be sent to kings. So strange how different care settings work 

Just reporting back from Bart’s, where I was on Friday. Just a single lavender (I don’t know why they aren’t just called purple!) for the BCR-Abl PCR test. Of course that’s on top of the usual biochem and virology ones that are ran. Tends to be 5 or 6 each time, but only one for the PCR test.