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[Diagnosis of acute leukemia in childhood]
The diagnosis of acute leukemia in childhood is based primarily on a morphologic evaluation of bone marrow smears. According to the French-American-British (FAB) classification three types (L1-L3) of acute lymphoblastic (ALL) and six types (M1-M6) of acute non-lymphoblastic leukemia (ANLL) are distinguished. Besides morphology cytochemical studies are used, particularly in cases where panoptic stains do not permit an unequivocal attribution to either ALL or ANLL. In addition, cytochemical reactions contribute to the distinction of myelocytic and monocytic types of ANLL. The heterogeneity of ALL in childhood is best revealed by immunological markers which permit to distinguish common, null, pre-T, T, pre-B and B subtypes. A discussion of published results demonstrates that the prognostic implications of these studies cannot be clearly evaluated as yet. By use of monoclonal antibodies new subtypes of ALL, and, very recently, of ANLL have been defined. One important aspect of these diagnostic refinements is to tailor antileukemic therapy to prognostic factors.
The diagnosis of acute leukemia in childhood is based primarily on a morphologic evaluation of bone marrow smears. According to the French-American-British (FAB) classification three types (L1-L3) of acute lymphoblastic (ALL) and six types (M1-M6) of acute non-lymphoblastic leukemia (ANLL) are distinguished. Besides morphology cytochemical studies are used, particularly in cases where panoptic stains do not permit an unequivocal attribution to either ALL or ANLL. In addition, cytochemical reactions contribute to the distinction of myelocytic and monocytic types of ANLL. The heterogeneity of ALL in childhood is best revealed by immunological markers which permit to distinguish common, null, pre-T, T, pre-B and B subtypes. A discussion of published results demonstrates that the prognostic implications of these studies cannot be clearly evaluated as yet. By use of monoclonal antibodies new subtypes of ALL, and, very recently, of ANLL have been defined. One important aspect of these diagnostic refinements is to tailor antileukemic therapy to prognostic factors.