Table 4.

Cold agglutinin disease: handling of samples.

Analysis	Material	Sampling	Handling of sample
Hemoglobin, blood cell counts	Blood	EDTA vacutainer	Prewarm at 37–38oC before analysis if problems with agglutination
Cold agglutinin titer, thermal amplitude, immunoglobulin quantification, electrophoresis, immune fixation	Serum or plasma	Blood is drawn into prewarmed vacutainers (For serum: No gel or additive). Place in warming cabinet or water bath at 37-38oC	Keep at 37–38oC until serum/plasma has been removed from the clot/cells, after which the sample can be handled at room temperature
Flow cytometry	Bone marrow aspirate (Too low sensitivity if performed in peripheral blood)	Add EDTA or heparin	Prewarming before analysis will often be sufficient. If not, wash cells at 37-38oC. For description, see Ulvestad et al. (9)

EDTA, ethylenediamine-tetraacetic acid.

Table first published in Journal of Blood Medicine 2019 by Berentsen et al. (14), reused under general permission (Creative Commons Attribution Non-Commercial License). Copyright: Berentsen et al.