Evaluation of the FAB classification of acute leukemia with special reference to differential diagnosis between acute lymphoblastic leukemia cells and acute myeloid leukemia cells.

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  • NAKAMURA Shinobu
    The Third Department of Medicine, Kanazawa University School Medicine
  • NAKANISHI Jin
    The Third Department of Medicine, Kanazawa University School Medicine
  • YOSHIDA Takashi
    The Third Department of Medicine, Kanazawa University School Medicine
  • OHTAKE Shigeki
    The Third Department of Medicine, Kanazawa University School Medicine
  • ITOH Keiko
    The Third Department of Medicine, Kanazawa University School Medicine
  • KOBAYASHI Kazumi
    The Third Department of Medicine, Kanazawa University School Medicine
  • MATSUDA Tamotsu
    The Third Department of Medicine, Kanazawa University School Medicine

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Other Title
  • 急性白血病ＦＡＢ分類の問題点　　特にリンパ球系白血病細胞と骨髄系白血病細胞の鑑別について
  • 特にリンパ球系白血病細胞と骨髄系白血病細胞の鑑別について

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Although, the FAB classification of acute leukemia has been increasingly used in Japan, there have various problems which have to be resolved. One of the most important problems of the classification is the difficulty of the differential diagnosis between acute lymphoblastic leukemia (L) and acute myeloid leukemia (M). In this study, in an attempt to increase the accuracy of the diagnosis, bone marrow smears obtained from 259 previously untreated patients with acute leukemia were examined by using histochemical stains-May-griinwald-Giemsa (M-G), peroxidase (PDX), Sudan black B (SBB), 3-3' diaminobenzidine (DAB) and esterase. Furthermore, the peroxidase activity in leukemic cells in bone marrow fragments from some of the patients was observed electron microscopically.<BR>Results are as follows:<BR>1. The positive rates of leukemic cells stained by SBB and DAB respectively significantly correlated with that of PDX.<BR>2. Most cases with low positive rates of PDX in leukemic cells revealed higher positive rates of leukemic cells stained by SBB. This finding made it possible to easily distinguish M from L.<BR>3. Since a higher positive rate of Phi body than that of Auer rod in acute myeloid leukemia was observed, DAB stain is a useful tool for cytologic diagnosis of myeloid leukemia (M).<BR>4. It was confirmed that ultrastructural demonstration of peroxidase activity in leukemic cells is of value in the differential diagnosis between L and M in cases with leukemic cells either negative or only weakly positive for PDX and SBB.

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