Acute leukemia

Classification

Morphology and cytochemistry Acute leukemias are classified according to the predominant morphology of the malignant cells. One widely used morphologic classification of acute leukemia was devised in the mid-1970s by a group of French, American and British ('FAB') investigators. There are three main FAB subtypes (I.I-L3) of acute lymphoblastic leukemia (ALL) and five (MI-M5) of acute myeloid leukemia (AML); the M1-M3 types reflect discrete stages of myeloid differentiation, while M4 and M5 cases have monocytic components. M6 and M7 denote erythroid and megakaryocytic leukemias, respectively. The precision of leukemia classification can be enhanced by investigating the activity of intracellular enzymes (e.g. myeloperoxidase, esterases and phosphatases) and the distribution of phospholipids and glycogen, by using cytochemical stains. Morphological and cytochemical analyses, however, are not sufficient for an accurate classification of all cases of leukemia. Thus, modern diagnostic procedures usually involve immunophenotypic, karyotvpic and molecular studies.

Immunophenotype A few monoclonal antibodies have lineage-restricted reactivity and are, therefore.

Table 1 Immunologie classification of acute lymphoblastic leukemia

Subtype

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