HEMATOLOGICAL AND CLINICAL EVALUATION OF LEUKEMIAS, USING CYTOCHEMICAL STAINS AND IMMUNOPHENOTYPING

Background: Leukemias are abnormal proliferation of hematopoietic cells, causing progressive infiltration of the marrow. It is the eleventh most common cancer in the world, and increasingly found now in developing countries. Two widely used classifications are used now, the FAB, and the WHO classification, which has got supplanted now, with increasing knowledge on cytomorphology and cytogenetics. This study, attempts to evaluate the role of cytochemistry as a cost-effective tool, in the various types of leukemias, and the role of immunophenotyping in a select few cases. Aim:- The main aim of the study, was to assess the type, and subtype of leukemia, using cytochemistry, and to find their concordance with immunophenotyping in a select few cases, as a cost effective tool in diagnosing it. Methods: 56 cases of leukemia, were identified by morphology and cytochemistry, using Sudan black B, and PAS stains. Immunophenotyping, was done in 6 cases selectively, and their concordance rate was determined. Results:- Out of 56 cases of leukemia, 36 were acute, rest 20, were chronic cases. AML, accounted for 43% of the cases, CML at 33%, and ALL at 22%. Anemia was seen, more in acute leukemias, especially ALL, followed by AML. Total count values were seen high in CML, followed by AML. Platelet counts, were less in acute leukemias, especially ALL,followed by lowest in AML. Splenomegaly, was the commonest feature seen in 21 cases. Immunophenotyping, was done in 6 cases, 4 cases were concordant, showing a 67% rate. Conclusion :- In a setting where there is a lack of facilities for flow cytometry, as in the developing countries, morphology combined with cytochemistry, still serves as the best means in diagnosing leukemia cases.