Morphological and Cytochemical Diagnosis with Flow Cytometric Analysis of Leukemias in a Tertiary Care Centre (Code-T0062)

Introduction: Leukemia, a group of hematologic malignancies, presents a significant diagnostic challenge due to its complex nature. Accurate and timely diagnosis is crucial for effective treatment. This study aims to evaluate the role of morphological, cytochemical, and flow cytometric analyses in diagnosing leukemia at a tertiary care center.

Aim and Objective:

• To diagnose leukemias based on morphology and cytochemistry.
• To correlate with flowcytometric analysis.

Methods: This prospective study included 120 patients with suspected leukemia, who were admitted to a tertiary care center. All patients underwent routine peripheral blood smear examination and bone marrow aspiration for morphological evaluation. Cytochemical staining, including myeloperoxidase (MPO), Sudan Black B, and periodic acid-Schiff (PAS), was performed. Flow cytometry was used for immunophenotyping to confirm the diagnosis and classify leukemia subtypes. The diagnostic results were compared, and the sensitivity and specificity of each method were calculated.

Results: Flow cytometry showed the highest sensitivity (95%) and specificity (92%) in leukemia diagnosis and classification, particularly in distinguishing between acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Cytochemical staining revealed important insights into the lineage of the leukemia cells, with MPO and Sudan Black B being most useful for diagnosing AML. Morphological examination provided essential preliminary data but was less definitive compared to the other methods.

Conclusion: Flow cytometry is the most reliable method for diagnosing and classifying leukemia, with significant contributions from cytochemical and morphological analyses. A combination of these diagnostic tools ensures accurate and timely leukemia diagnosis, leading to better clinical management.

Keywords: Leukemia, Flow cytometry, Cytochemical staining, Morphological diagnosis, Immunophenotyping, Hematologic malignancies.