[Strategy for diagnosing hematological malignancies--a proposal from hematologists to laboratory medicine]

Many laboratory methods are used to diagnose acute myelocytic leukemia(AML) including morphological analysis, phenotypic analysis, chromosomal and genetic analysis of leukemic blasts. The FAB classification is widely used for the diagnosis and classification of AML because of its convenience. This classification is mainly based on morphological and cytochemical results which are well established and economical methods. Phenotypic analyses using flow cytometry provides useful information regarding the lineage and maturation status of leukemic cells. Chromosomal and genetic data are thought to reflect the biological characteristics of leukemic cells and certain chromosomal abnormalities strongly associated with the good or poor prognoses of AML patients. Genetic analysis of AML blasts became available recently in a clinical field, along with progress in molecular analysis of leukemia but its clinical significance in AML has not been well established yet. When clinicians see patients, the diagnosis of AML is usually made based on the morphological and phenotypic data of peripheral and bone marrow slides, then chromosomal and genetic data are usually received by doctors after the initial therapy. It is very important to understand the significance of all laboratory data and to integrate all results not only for diagnosis but also for management of patients with AML.