Clinical and Hematological evaluation of leukemias, using cytochemical stains and immunophenotyping

INTRODUCTION: 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. Two widely used classification 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 in the various types of leukemias, as well as the role of immunophenotyping in a select few cases, in patients which were referred to the Department of pathology, at Thanjavur Medical College. AIM OF THE STUDY: The main aim of the study was to assess the type and subtype of leukemia, using cytochemistry and their morphology, as well as to see the distribution of demographic data among them, and to evaluate their clinical and hematological presentation. RESULTS: 56 cases of leukemia, identified by morphology and cytochemistry, were seen in the study between January 2015 and June 2015. Cytochemical stains used were Sudan black B, and PAS. Out of the total, 36 cases were acute, rest were chronic cases. AML accounted for 43% of the cases, followed by CML at 33%, and ALL at 22%. A slight female preponderance was seen in the number of AML cases, but a male predominance in ALL. ALL was common in the child age group, followed by AML, and CML in the 21-40 age group, followed by AML.CLL was seen mostly above 40 yrs of age. 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 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 majority of centres in the developing countries, morphology combined with cytochemistry, still serves as the best means in diagnosing leukemia cases