AUTOMATED IMAGE-ANALYSIS OF SILVER STAINABLE NUCLEOLAR ORGANIZING REGIONS IN CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA

Routine, airdried bone marrow smears from consecutive, nonselected cas es of Childhood ALL were stained for Nucleolar Organising Regions (Ag- NOR's). 9 pre-induction samples at diagnosis and 9 samples at 6 months off (chemo-) therapy were used to study the applicability of fully au tomated image analysis for diagnosis and classification. Using strict quality control, patients were compared for average number of Ag-NOR's per blast, average area of Ag-NOR's and average area of the 5 largest Ag-NOR's using commercially available software and a non-informed mat hematician operator. Patient groups differed significantly (Wilcoxon's two sided rank-sum test) for mean number of Ag-NOR's per nucleus (p < 0.01), for mean Ag-NOR area (p < 0.05) and for mean area of 5 largest Ag-NOR's (p < 0.001). Using a scattergram plot for mean area of 5 lar gest Ag-NOR's against mean number of Ag-NOR's per nucleus, virtually c omplete separation between groups was obtained. The authors conclude t hat the method is sensitive and suitable enough to warrant further stu dies into the value as an independent prognostic parameter.