White blood cell suspect flags and white blood cell histogram pattern in acute leukemias.

Kunal Ostwal, Anne Wilkinson


The  objective  of  the  study  was  to  determine  whether  the  information  of  combined  flagging  and  histogram recognition can be of aid in identifying cases of acute leuk emia and their morphological type. 20 blood samples of suspected and diagnosed cases of acute leukemia in one and a half years in our hospital were studied. The blood samples  were collected in  EDT A and analyzed in  an automated  3-part differential cell counter .

The diagnosis of leuk emia was confirmed after peripheral smear examination and in some cases bone marrow examination of the patient. The cell counts, White blood cell(WBC) suspect flags and histogram generated from all these cases were collected  and  analyzed  to  try  to  find  its  utility  in  predicting  the  morphological type  of  acute  leuk emia. Twenty  cases  of acute leukemia were analyzed, 16 (80%) out of which were acute myeloid leukemia (AML) and 4 (20%)were acute lymphoid leuk emia (ALL).All the 4 cases of ALL shows M2G1G2 flags and only one case showed G3 flag. In AML 15 cases (93.75%).showed combined flags M2G1G2. Out of these 15, 3 cases showed additional G3 flag and 2 showed additional L1 flag. One case showed M2G1G3 flag combination. Thus, all acute leuk emias whether of myeloid or lymphoid  type,  predominantly  show  M2G1G2  flags.  Hence  Complete  Blood  Count  (CBC)  would  help  us  in  the diagnosis  of  acute  leuk emias.

Keywords:  White blood  cell  flags,  Histogram,  Acute  Leukemias.

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