Diagnosis of leukemia
Last reviewed: 23.04.2024
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In the analysis of peripheral blood in patients with acute leukemia, blast cells, anemia, thrombocytopenia are found. However, in 10% of children with acute leukemia, there are no abnormalities in the analysis of peripheral blood. If suspected of acute leukemia, bone marrow puncture should be performed. Myelogram is characterized by oppression of erythro- and thrombocytopoiesis and an abundance of blast elements. Cytochemical studies are useful for differential diagnosis of acute lymphoblastic leukemia and onLL. To identify variants of acute lymphoblastic leukemia, searches for specific markers using labeled monoclonal antibodies are necessary.
With the aim of combining the cytochemical and morphological basis for the differentiation of acute leukemia in 1976-1980, The FAB (Franco-American-British - FAB) classification was established, clear and accessible.
Differential diagnosis of leukemia. Acute leukemia must be differentiated from leukemoid reactions in severe bacterial infections, drug disease, poisoning. Unlike leukemia, such patients do not have a pronounced proliferative syndrome, bone damage, bone marrow and peripheral blood are present to varying degrees all the transition elements between blasts and mature forms. Sometimes certain difficulties are caused by differentiation of acute leukemia from infectious mononucleosis, infectious lymphocytosis. The clinical picture in most cases makes it possible to differentiate these diseases (angina, fever, hepatosplenomegaly, painful on palpation and enlarged lymph nodes are typical for mononucleosis), but the final judgment is still based on morphology: abundant basophilic cytoplasm, lack of changes in the nucleus that characterize leukemia allow diagnosis mononucleosis. In all doubtful cases, it is necessary to make a myelogram, which is indicated in any unclear anemia, thrombocytopenia, pancytopenia, hepatosplenomegaly, generalized or sharp local enlargement of the lymph nodes.
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