Diagnostic approaches to acute promyelocytic leukaemia

Delivering the most effective clinical therapy in acute promyelocytic leuka emia (APL) is dependent on accurately making the diagnosis. The morphologic al diagnosis can be improved by detecting the presence of a specific chromo some translocation, the t(15;17)(q22;q21). This can be achieved using cytog enetics, RT-PCR, FISH and anti-PML monoclonal antibody. The optimal approac h will be rapid, accurate and readily integrated into the routine haematolo gy laboratory. Immunofluorescent detection of microparticulate PML protein fulfils these criteria, however, karyotyping will also detect the variant t ranslocations and remains the 'gold-standard'.