White Cell Disease States

Characteristic of Alder-Reilly

Large Azurophilic Granules

Characteristic of Chediak-Higashi

Large lysosomes (Fusion of primary granules)

Characteristic of May-Hegglin

Large platelets

Dohle bodies in Segs, Monos, and Lymphs

Characteristic of Pelger-Huet

Hyposegmented Polys

WHO Classification of Acute Myeloid Leukemias

>20% blasts

AML with recurrent chromosomal abnormalties

• t(8;21)

• Inv(16) or t(16;16)

• t(15;17)

• 11q23

French, American, British (FAB) classification of Acute Myeloid Leukemias

>30% Blasts

AML Predominant Cell Seen (M0-M7)

M0 - Myeloblast without differentiation

M1 - Myeloblast with minimal maturation

M2 - Myeloblast with maturation

M3 - Promyelocyte (APL)

M4 - Myeloblast and monoblast (AMMoL)

M5 - Monoblast (AMoL)

M6 - Erythrocytic series (Erythroleukemia)

M7 - Megakaryocyte (Megakaryocytic leukemia)

What do AMMoL and AMoL stand for?

Acute Myelomonocytic Leukemia and Acute Monocytic Leukemia

What is the abnormality associated with Acute Promyelocytic Leukemia?

t(15;17) Retinoic Acid Receptor a-gene

What is the abnormality associated with CML?

t(9;22) Philadelphia Chromosome

What is the abnormality associated with AML (M2)?

t(8;21)

What is the abnormality associated with AML (M4Eo Variant)?

t(16;16) or inv(16)

What is the abnormality associated with AML (M5)?

11q23

Precursor B-cells for Acute Lymphoblastic Leukemia/ Lymphoma

CD 10⁺, CD 19⁺, CD 22⁺, CD 24⁺

Precursor T cells for Acute Lymphoblastic Leukemia/ Lymphoma

CD 2⁺, CD 4⁺, CD 5⁺, CD 8⁺

Indicators of Chronic Lymphocytic Leukemia/ Lymphoma (CLL)

(WBCs and Precursor cells)

Mature lymphocytes (soccer ball nucleus)

CD 19⁺, CD 20⁺, CD 23⁺, and CD 5⁺

Indicators of Hairy Cell Leukemia (HCL)

(WBCs and Precursor cells)

Mature lymphocytes with cytoplasmic projections, pancytopenia, splenomegaly, TRAP positive

CD 103⁺, CD 11c⁺, CD 25⁺

Indicators of Multiple Myeloma (Plasma cell myeloma)

• Bone pain (multiple lytic lesions)

• Sheets of plasma cells in bone marrow

• Rouleaux

• Increased serum protein (IgG or IgA monoclonal spike) and Calcium

• Urinary excretion of light chains (Bence Jones Proteins)

Indicator of Plasma cell leukemia

>20% plasma cells in peripheral circulation

Indicators of Waldenstrom Macroglobulinemia

• Normal bone scan

• Increased IgM and serum viscosity

Indicators of Hodgkin Lymphoma

• Reed-Sternberg cells

• Stepwise predictable spread

• Bi-modal incidence

Specific Esterase

(What does it indicate? What is the significance?)

Indicates: Granulocyte precursors

Significance: Negative in Monocytic leukemias

Non-Specific Esterase

(What does it indicate? What is the significance?)

Indicates: Monocytic precursors

Significance: Positive in Monocytic Leukemias

CD 13, CD 33

(What does it indicate? What is the significance?)

Indicates: Myeloid lineage

Significance: Myeloid/Monocytoid Leukemias

CD 41, CD 42, CD 61

(What does it indicate? What is the significance?)

Indicates: Megakaryocytes

Significance: Megakaryocytic leukemia

CD 14, CD 64

(What does it indicate? What is the significance?)

Indicates: Monocyte lineage

Significance: Monocytoid Leukemias

CD 2, CD 3, CD 5, CD 7

(What does it indicate? What is the significance?)

Indicates: T-lineage

Significance: T-cell neoplasms

CD 10, CD 19, CD 22

(What does it indicate? What is the significance?)

Indicates: B-lineage

Significance: B-cell neoplasms

CD 34

(What does it indicate? What is the significance?)