Reliability and limitations of cytochemistry in diagnosis of acute myeloidleukemia - Minireview

Accurate characterization of leukemic blast cells is an important prerequis ite of the precise diagnosis of acute myeloid leukemia and has a great impa ct on therapy and prognosis. The purpose of this review is to consider the present possibilities and limitations of enzyme cytochemistry and to emphas ize how cytochemistry may contribute to the final classification and differ ential diagnosis of acute myeloid leukemia. The role of conventional enzyme cytochemistry, either dominant or subsidiary, in the discrimination of acu te myeloid leukemia subgroups is discussed. The survey confirms the necessi ty of immunological marker analysis in the accurate diagnosis of minimally differentiated myeloid leukemias and acute leukemia of megakaryocytic linea ge. In these cases, the cytochemical evaluation provides insufficiently rel evant information regarding blast cell origin. On the other hand, cytochemi cal investigation is appreciated to be dominant over immunophenotyping in c haracterizing majority of acute myeloid leukemia subgroups, because of the availability of standardized and sufficiently specific cytochemical reactio ns and, because of the lack of specificity of the many of immunological mar kers against myeloid antigens. The immunocytochemical, cytogenetic, molecul ar biology and electron microscopic studies shortly mentioned in this revie w supplement the information for correct diagnosis of acute myeloid leukemi a.