A Study on Morphological, Cytochemical, and Flow Cytometric Analysis of Leukemias in a Tertiary Care Center (Code-T0074)

Introduction: Leukemia, a group of hematological malignancies, is characterized by the clonal proliferation of abnormal white blood cells. Accurate diagnosis and classification of leukemia are crucial for determining prognosis and tailoring appropriate treatment strategies. Morphological examination, cytochemical staining, and flow cytometric immunophenotyping are integral diagnostic tools for leukemia assessment, offering complementary information that enhances diagnostic accuracy.

Aims and Objective:

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

Methodology: A cross-sectional study was conducted on patients presenting with suspected leukemia over a period of 18 months. Bone marrow aspirates and peripheral blood samples were analyzed morphologically and subjected to cytochemical staining using techniques such as myeloperoxidase (MPO) and periodic acid–Schiff (PAS). Flow cytometry was performed to identify immunophenotypic markers for precise subtyping of leukemia. Data were statistically analyzed to assess the correlation and diagnostic concordance between these methods.

Results: The study included 150 cases of leukemia, comprising 60 cases of acute lymphoblastic leukemia (ALL), 50 cases of acute myeloid leukemia (AML), and 40 cases of chronic leukemias. Morphological and cytochemical analysis identified AML with an accuracy of 85% and ALL with an accuracy of 88%. Flow cytometry provided definitive subtyping in 95% of cases, significantly improving diagnostic precision. The combined approach enhanced diagnostic accuracy and reduced misclassification, particularly in ambiguous cases.

Discussion: The integration of morphological, cytochemical, and flow cytometric techniques offers a robust framework for leukemia diagnosis. While morphology and cytochemistry remain valuable for initial assessment, flow cytometry provides unparalleled precision in immunophenotyping, enabling accurate classification and prognostic evaluation. The study highlights the importance of a multidisciplinary approach in the diagnosis of hematological malignancies.

Conclusion: A combined approach using morphology, cytochemistry, and flow cytometry significantly enhances the diagnostic accuracy and subtyping of leukemias. This integrated methodology ensures comprehensive evaluation, aiding in optimal patient management and treatment planning. The findings emphasize the necessity of utilizing advanced diagnostic modalities in tertiary care settings to achieve superior clinical outcomes.

Keywords: Leukemia, Morphology, Cytochemistry, Flow Cytometry, Immunophenotyping, Diagnosis, Hematological Malignancies.