A study for evaluation of different diagnostic approaches in acute leukemia in Egypt

• Published in: Hematology (Luxembourg) Vol. 11; no. 2; p. 87
• Main Authors: Mahmoud, Lotfy A, Shamaa, Sameh S A, Salem, Mohammad A, Aladle, Doaa A, Goda, Enas F A
• Format: Journal Article
• Language: English
• Published: England 01-04-2006
• Subjects: Adolescent; Adult; Analysis of Variance; Female; Genetic Markers; Histocytochemistry - methods; Humans; Immunophenotyping - methods; In Situ Hybridization, Fluorescence; Karyotyping; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - genetics; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics; Prognosis; Reverse Transcriptase Polymerase Chain Reaction - methods; Statistics, Nonparametric
• ISSN: 1024-5332
• DOI: 10.1080/10245330600574300

Cytomorphology, cytochemistry, immunophenotyping, in addition to cytogenetic and molecular analyses have specific roles in the diagnosis and management of acute leukemias. This work was designed as a comparative study of different available methods for diagnosis of acute leukemia. The study comprised 47 cases with acute leukemia (21 cases with ALL and 26 cases with AML). Peripheral blood and bone marrow samples were subjected to through morphological examination of Leishman-stained smears, cytochemical analysis, immunophenotyping, conventional cytogenetic banding analysis, fluorescence in situ hybridization (FISH) for selected cases, and RT-PCR for detection of BCR-ABL rearrangement. The results of the study revealed that careful examination of Romanowsky-stained peripheral blood and BM films is fundamental in the diagnosis of acute leukemias, and when considered together with clinical and hematological features, indicates which of the more specialized techniques are most likely to be useful. The major role of cytochemistry was in the diagnosis of AML, while the major role of immunophenotyping was in the diagnosis of acute leukemia, which is not obviously myeloid. Apart from identification of chromosomal abnormalities unique to specific subtypes of leukemia, cytogenetic analysis had a salient impact on anticipating the prognosis and treatment outcome in acute leukemias. We could conclude that the techniques used in this study are considered complementary rather than alternatives and that stepwise employment of strategies is more cost effective than doing all the tests simultaneously.