Trajan supporting bone marrow diagnostics at New Cross Hospital

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Case Study Summary
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Overview summary:
Trajan has been working closely with New Cross Hospital’s pathology department to improve performance of bone marrow trephine (BMT) biopsy testing. Bone marrow diagnostic tests are usually undertaken for cancers that are most likely to affect bone marrow such as lymphoma & leukemia.

An ongoing challenge for New Cross has been a higher than normal test repeat rate on BMT cases, due to tissue lifting off microscope slides during processing.

With minimal failure & repeat rates, using Trajan slides provides fast turnaround time for patient results.

Challenge identified and actions taken :
An ongoing challenge for New Cross Hospital has been a higher than normal test repeat rate on bone marrow trephine (BMT) biopsy sections due to tissue lifting off the surface of microscope slides during processing resulting in specimen loss.

BMT biopsy is carried out as part of assessment of various hematological conditions to evaluate marrow cellularity, cell distribution & morphology.

The bone marrow sample required is usually taken from the patient’s hip bone using a trephine needle.

Taking into account complexity of the trephine biopsy procedure & patient discomfort the small volume sample (~1.5-2 cm length) becomes highly valuable in supporting patient diagnosis.

Image below Sectioning ~1-2 µm thin bone marrow trephine specimens using microtome.



Trajan supplied specialised adhesive microscope slides for review in BMT cases by New Cross Hospital. The initial verification & validation exercise as part of the laboratory’s ISO15189 compliance showed Trajan Series 3 adhesive microscope slides dramatically increased the retention of BMT tissue sections on test slides.

With minimal failure & repeat rates, Trajan’s Series 3 adhesive microscope slides provide fast turnaround time for patients as results for H&E & other IHC stains are available within 48-72 hours of carrying out the biopsy depending on the applied protocol.
Impacts / outcomes:
Trajan Series 3 adhesive microscope slides assist investigation of BMT biopsy samples with an aim to support diagnosis and management of hematological conditions. The slides provide excellent specimen adhesion and the mounted sections can be used for an array of routine and IHC stains.

Since the adoption of the Series 3 adhesive microscope slides, they have been used in more than 235 bone marrow trephine biopsy cases at New Cross Hospital and have demonstrated outstanding results with regards to stain quality as well as minimum repeat rates due to tissue loss.

Previously each repeat stain for a repeat test would take a day and a half to complete (cut and dry on overnight and stain the next day). With Trajan Series 3 Adhesive slides, due to their strong adhesion quality, no repeat tests are required.

Trajan Series 3 Adhesive slides are now used for ALL Bone Marrow Trephine biopsies at New Cross Hospital.

National Clinical / Policy Priorities:

NHS England’s 2016-17 Business Plan – https://www.england.nhs.uk/wp-content/uploads/2016/03/bus-plan-16.pdf

“Cancer is increasing – there will be 300,000 new diagnoses a year by 2020. Following publication of the Cancer Taskforce report in July 2015 we will drive down waiting times, increase diagnostic capacity and develop a modern national radiotherapy network.

Trajan Series 3 adhesive microscope slides assist investigation of BMT biopsy samples with an aim to support diagnosis and management of hematological conditions, helping to improve patient experience and outcomes.

Image below: Robust tissue adhesion with H&E stain of bone marrow trephine (BMT) biopsy section on Trajan Series 3 adhesive microscope slide.



Image below: Minimal background staining with the reticulin silver stain of bone marrow trephine (BMT) biopsy section on Trajan Series 3 adhesive microscope slide.


Supporting quote for the innovation from key stakeholders:
“Since the adoption of Series 3 adhesive microscope slides from Trajan Scientific and Medical, we have used them in more than 235 bone marrow trephine biopsy cases which demonstrated outstanding results with regards to stain quality, as well as minimum repeat rates due to tissue loss.”
Glyn Woodward, Quality Lead, New Cross Hospital.

“Trajan Series 3 adhesive microscope slides have worked well with these BMT biopsy specimens as they provide much improved tissue adhesion during staining. Their positively charged hydrophilic nature prevents any tissue loss in this particular specimen type.” “We do not have to worry about tissue lifting off the slide surface, which has helped us with our turnaround time too because we don’t have to repeat stains where specimens have fallen off.”
Pam Leach, Immunohistochemistry Lead, New Cross Hospital

To read the full Testimonial - click here.
Which local or national clinical or policy priorities does this innovation address:
Plans for the future:
N/A
Tips for adoption:
Finding time to complete the tests using Trajan Series 3 Adhesive slides was the only real challenge.

New Cross Hospital completed 6-7 cases and witnessed vast improvements in results with regards to stain quality as well as minimal repeat rates due to tissue loss. As a result, a decision was taken based around the improved quality using Trajan Series 3 Adhesive slides.
Contact for further information:
Azeem Hanif, Commercial Projects Executive
Trajan Scientific and Medical

Direct: +44 (0) 1908 568 844
Mobile: +44 (0) 7534 140 969

ahanif@trajanscimed.com
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