EVALUATION OF ACUTE LEUKAEMIAS BY FLOW CYTOMETRY AND ITS ASSOCIATION WITH DIAGNOSIS USING MORPHOLOGICAL AND SPECIAL STAINING TECHNIQUES
DOI:
https://doi.org/10.65605/a-jmrhs.2026.v04.i02.pp622-627Abstract
Background: Acute leukemia (AL) is a group of hematological malignancies with the common feature of the uncontrolled proliferation of immature cells. It is crucial to diagnose and lineate a specimen accurately to be able to classify and manage it properly. The conventional methods such as morphology and cytochemical staining have remained useful and flow cytometry has played a more prominent role in the immunophenotypic characterization of leukemic blasts.
Objective: To assess the value of cytochemical staining and flow cytometry in the diagnosis of acute leukemia and to correlate morphological and cytochemical with flow cytometric diagnosis.
Materials and Methods: This is a cross-sectional study of 60 suspected cases of acute leukemia. In all cases, peripheral smear examination, bone marrow morphology and periodic acid Schiff (PAS) and myeloperoxidase (MPO) cytochemical staining were carried out. Definitive lineage was then determined by flow cytometric immunophenotyping. The flow cytometric findings were correlated with the morphological and cytochemical diagnosis.
Results: We observed that on flow cytometry analysis 31 cases (51.7%) were diagnosed as AML and the remaining 29 cases (48.3%) were diagnosed as ALL. Morphological diagnosis was in good agreement with flow cytometry. Of the 28 cases morphologically diagnosed as AML, 100% of these cases were confirmed as AML by flow cytometry. Contrary to this, 32 cases diagnosed as ALL, 29 cases (90.6%) matched with flow cytometric diagnosis while three were re-classified as AML. When the discordant ALL cases were observed, the expression of myeloid markers CD13, CD33 and CD117 was evident in the absence of good cytochemical staining.
Conclusion: Morphology and cytochemical staining are still valuable preliminary diagnostic procedures in acute leukemia. Flow cytometry, however, offers greater diagnostic accuracy and is an important tool when the diagnosis is difficult and the morphology is poorly differentiated. The integrated use of morphology, cytochemistry and immunophenotyping is still essential for the correct classification of acute leukemia.
