International Journal of Hematology

ISSN 2997-1036

International Journal of Hematology | Vol. 3, No. 1, January 2012 | pp. 1–8
DOI: 10.46882/2012/IJH/000025

Original Article

Title: Cytochemical and morphological classification of acute leukemias in a tertiary health facility

Names of Authors: Y. Z. Ibrahim¹, A. B. Okafor², C. D. Danjuma³

Authors’ Affiliations: ¹Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; ²Department of Pathology, University of Ibadan, Ibadan, Nigeria; ³Department of Haematology, University of Maiduguri, Maiduguri, Nigeria

Abstract: Accurate differentiation between acute myeloid leukemia and acute lymphoblastic leukemia is essential for selecting appropriate induction chemotherapy. This descriptive study classified 62 newly diagnosed adult acute leukemia cases using peripheral blood films, bone marrow aspirates, and standard cytochemical stains, including Myeloperoxidase, Sudan Black B, and Periodic Acid-Schiff. Acute myeloid leukemia was diagnosed in 58.1% (36 of 62) of the cases, while acute lymphoblastic leukemia accounted for 41.9% (26 of 62). The acute myeloid leukemia cases were subclassified using the French-American-British system, where the M2 (acute myeloid leukemia with maturation) and M4 (acute myelomonocytic leukemia) variants were the most common, representing 33.3% and 22.2% of myeloid cases, respectively. Myeloperoxidase reactivity showed a high specificity (96.4%) for myeloid lineage determination. Misclassification occurred in 4.8% of cases when evaluating poorly differentiated blastic patterns without cytochemical stains. In resource-limited settings lacking flow cytometry, systematic cytochemical staining remains a reliable and affordable diagnostic protocol for acute leukemia classification.

Keywords: Acute myeloid leukemia, acute lymphoblastic leukemia, cytochemistry, myeloperoxidase, bone marrow aspirate

Manuscript Timeline: Received: October 14, 2011; Revised: November 20, 2011; Accepted: December 08, 2011; Published: January 11, 2012