Pathologic diagnosis of acute lymphocytic leukemia.
With present knowledge, the optimal management of individual patients with acute leukemia requires that every case be studied by morphology, cytochemistry, cytogenetic, immunologic and molecular techniques. An algorithm for diagnostic evaluation and classification of ALL is provided in Fig. 11. Other techniques, such as DNA or cDNA [figure: see text] microarray, are at present important research tools but have not yet had a major effect on patient care. More detailed studies of individual patients need to be conducted at specialized cancer centers, where preservation of cells, DNA, RNA, or protein is possible. Such investigations will yield important information on the clinical importance of the expression of various markers, the prevalence and relevance of bilineage and biphenotypic leukemias, and above all will reveal the mechanisms of leukemogenesis and of disease evolution. Such insights will further aid clinicians in treating ALL and in preventing refractory disease.
Lai
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Department of Hematopathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Hirsch-Ginsberg
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Bueso-Ramos
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D000328:Adult; D000465:Algorithms; D014408:Biomarkers, Tumor; D001853:Bone Marrow / Q000473:pathology; D001856:Bone Marrow Examination; D002648:Child; D002869:Chromosome Aberrations; D004253:DNA Nucleotidylexotransferase / Q000032:analysis; D003937:Diagnosis, Differential; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007951:Leukemia, Myeloid / Q000175:diagnosis; D017254:Leukemic Infiltration; D008223:Lymphoma / Q000175:diagnosis; D009363:Neoplasm Proteins / Q000032:analysis; D009369:Neoplasms / Q000175:diagnosis; D014411:Neoplastic Stem Cells / Q000737:chemistry / Q000473:pathology; D009195:Peroxidase / Q000032:analysis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D011379:Prognosis; D019310:Pseudolymphoma / Q000175:diagnosis; D013048:Specimen Handling; D013194:Staining and Labeling; D009626:Terminology as Topic; D014178:Translocation, Genetic
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D009195:Peroxidase; D004253:DNA Nucleotidylexotransferase