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Abstract Leukemia is a collective term of malignant disorders of the pluripotent stem cells resulting in senseless overproduction of white blood cells on the expense of other normal hemopoietic cells. The present work was designed as a comparative study of different available methods for diagnosis of leukemia to: - Improve the diagnostic accuracy. - Determine how these techniques could substitute or complement each other. - Verify cost-effectiveness of these approaches. - Predict the prognosis and outcome in patients with leukemia. This study comprised 72 newly diagnosed leukemic patients beside 15 normal subjects who were taken as a control group. In conclusion, the techniques used in this study are considered complementary rather than alternatives. However, stepwise employment of strategies is more cost effective than doing all the tests simultaneously. Until a gold standard method for diagnosis of leukemia is available, this study recommend the following batteries of tests to be done in each case of leukemia: o The first diagnostic step is the examination of Romanowesky-stained smears of peripheral blood and/or bone marrow which is still an essential step in the diagnosis of most leukemias. o The major role of cytochemical staining is in the diagnosis of myeloid leukemias. o Immunophenotypic analysis is used to distinguish between ALL and AML and to refer to the subtypes of acute leukemia (e.g. CD14 in acute monocytic leukemia). It has the major role in the diagnosis of CLL. o Apart from identification of chromosomal abnormalities unique to specific subtypes of leukemia, karyotyping had a salient impact on anticipating the prognosis and treatment outcome in various leukemias. o The molecular procedures improve the ability to diagnosis and determine the risk group in leukemias. They also open an avenue for prospective molecular therapy in the near future. |