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Test Directory -  VMA


HMMA, Vanillylmandelic acid

Clinical Indications

Screening of suspected neuroblastoma. 

Test Includes

Vanillylmandelic acid (VMA) and Homovanillic acid (HVA)

Request Form 

Combined Pathology Blood form (Yellow/Black)


Referral test: Analysed by Chemical Pathology, Great Ormond Street Hospital if specific criteria met.

Specific Criteria

Screening of suspected neuroblastoma.

Turnaround Time

2 weeks


Random Urine


5 ml


White Capped Universal


Samples should be transported to laboratory immediately.

Causes for Rejection

Unlabelled sample. Not meeting specific criteria for analysis. Delay in sample reaching laboratory

Reference Range

Results are expressed as a ratio to creatinine

Age Range

VMA umol/mmol creat,

HVA umol/mmol creat,

Less than 1 year

Less than 20

Less than 15

Over 1 year

Less than 10

Less than 10

Reference; Referral laboratory



About 90% of children with a neuroblastoma will produce excess VMA and HVA. Intense emotional and physical stresses can cause moderate to large temporary increases in VMA levels. For monitoring of treatment decreasing VMA concentrations indicate a response to treatment; stable or increasing levels indicate that the treatment is not effective.

Lab. Handling

Processing: Store promptly at -20C in separating freezer (CB40)
: VMA and send frozen via courier or BPRO and save at -20C in separating freezer (CB40).


Version 1.0 / January 2015                                                                                                     Approved by: Consultant Biochemist