Diagnosis of leukemia

Acute lymphoblast Acute myeloid Chronic Chronic myeloid

leukemia(ALL) leukemia(AML) lymphoid leukemia(CML)
leukemia(CLL)
RBC: decrease (anemia) RBC: decrease RBC: decrease RBC: decrease
CBC PLTs: decrease (anemia) (anemia) (anemia)
(thrombocytopenia) PLTs: decrease PLTs: decrease PLTs: decrease
WBC: increase with (thrombocytopenia) (thrombocytope (thrombocytopenia)
neutropenia WBC: variable nia) WBC: increase
WBC: markedly granulocytes (N, E,
increase B)
RBC: normocytic, RBC: normocytic, RBC:
Blood normochromic normochromic normocytic, WBC:70%
film WBC:90% WBC: 90% normochromic granulocyte with
lymphoblasts, are seen Myoblasts are seen. WBC:70% myeloid series
10% prolymphocyte, 10% mature cell (N, abnormal 30% myeloblast.
lymphocyte. B, E) and band form lymphocytes
with smudge
cell (rupture of
lymphocyte)
30%
prolymphocyte,
lymphoblast.
 Acute lymphoblast
leukemia(ALL)
Normal bone marrow
Bone contains 5% or less ALL
In leukemia, abnormal blasts
marrow constitute between 30%-
90% or 100% of bone
marrow.
Spinal tap
If bone marrow examination
confirms ALL, a spinal tap
(lumber puncture) may be
performed. a sample of CSF
fluid with leukemia cell is a
sign that the disease has
spread to the nerves system.
In most case of childhood
ALL.
Leukemia cells are not found
in the CSF (cerebrospinal
fluid).
Cytochemistry
Special 1)Acid Phosphatase and
test PAS (periodic acid
Schiff)) cytochemical
stain
2)Immunophenotyping
tests (CD marker
(cluster of
differentiation) to
differentiate between
B lymphocyte (CD ,19,
20, 21, 22)
T lymphocyte (CD 3, 7)
Acute myeloid Chronic Chronic
leukemia(AML) lymphoid myeloid
leukemia(CLL) leukemia(CML
)
Having at least 20% In people with
blasts in the marrow CML
or blood is generally The bone
required for a marrow is often
diagnosis of AML hypercellular
normal range of blast because it is full
count is 5% or less. pf leukemia cells
(specially
myelocyte)
Cytochemistry Cytochemistry Cytochemistry
cytochemical stain:
1) Sudan black stain: stains
2)Immunophenotyping cytochemical
tests:
phospholipids and
lipoproteins present in (CD marker) to
stain:
Neutrophile
monocytes and granulocytes differentiate between:
(SBB)POSITIVE. B lymphocyte (CD ,19, alkaline
2) Myeloperoxidase stain: phosphates
20, 21, 22)
stain peroxidase present in
T lymphocyte (CD 3, 7) (NAP)
primary granules of myeloid
cells, demonstrate presence cytogenetic:
of Auer rods (MPO) POSITIVE. in some cases of CLL, cytogenetic:
cytogenetic: part of a chromosome Philadelphia
are used for genetic analysis. may be missing. this is
cytogenetic testing can detect
chromosome and
translocations
called a deletion. BCR-ABL gene
of chromosomes and genetic the most common This type of test is
abnormalities. deletions occur in parts used to confirm the
-A translocation (8,21) of chromosomes 13,11 diagnosis of CML
For ex, means a part of or 17
chromosome 8 is located on
chromosome 21 and vice
versa (seen most often in
patients with M2
-translocation between
chromosome 15 and 17 (seen
most often in patients with
M3)