Summary LEUKEMIA -- HEMA 2

Lymphocytes............................................................................................................................................ 2
Cytochemical Stains................................................................................................................................. 3
Enzymatic.......................................................................................................................................................... 3
LAP Score.......................................................................................................................................................... 4
Nonenzymatic................................................................................................................................................... 5
Neoplasms...............................................................................................................................................................6
Leukemia........................................................................................................................................................7
FAB Classification: French-American-British Classification....................................................................... 7
WHO Classification................................................................................................................................................. 8
Acute Myeloproliferative Leukemia (AML)............................................................................................................ 8
Myeloproliferative Neoplasms............................................................................................................................. 11
Chronic Myeloid Leukemia (CML)..................................................................................................................11
Polycythemia Vera (PV)...........................................................................................................................11
Acute Lymphoid Leukemia (ALL).................................................................................................................. 12
FAB Classification of ALL........................................................................................................................ 12
Chronic Lymphoproliferative Leukemic Disorders (CLLD)............................................................................ 13
Chronic Lymphocytic Leukemia (CLL).....................................................................................................13
Hairy Cell Leukemia (HCL)......................................................................................................................13
Lymphomas and Other Leukocyte Disorders.................................................................................................14
Hodgkin's Lymphoma and Non-Hodgkin’s Lymphoma..................................................................................14
Mycosis Fungoides or Sezary Syndrome......................................................................................................14
Mantle Cell Lymphoma (MCL).......................................................................................................................14
Burkitt Lymphoma..........................................................................................................................................14
Multiple Myeloma (MM)................................................................................................................................. 14
Waldenstrom’s Macroglobulinemia (WM)......................................................................................................14
Heavy Chain Disease (HCD).........................................................................................................................14

, Lymphocytes
Leuko - white, cyte - cell – white blood cells (WBC) circulate and function as our body’s main line of defense. WBCs
protect the body against bacteria, viruses, and other foreign bodies. WBCs arise from the Common Myeloid Progenitor
(CMP) or CFU-GEMM (Colony forming unit – granulocyte, erythrocyte, monocyte, and megakaryocyte) progenitor cell. As
this cell line matures, multilineage colonies form: CFU-GM (granulocyte and macrophage), CFE-Meg (megakaryocyte), and
CFU-E (erythroblast). WBCs are generally classified according to:
- Granules (granulocytic or non granulocytic)
- Nuclear segmentation
- Function as either phagocytic or immunologic

The granulocytes – neutrophils, eosinophils, and basophils – contain distinct granules in their cytoplasm.
However, non granulocytes – monocytes and macrophages – lack prominent granules. This classification is mainly based
on their reaction to Romanowsky or Wright stains.

Granulocyte Characteristic Stain of their Rational Picture
granules

Eosinophil Band shaped or Bright orange-pink Affinity for eosin
segmented into only 2 (acidic component of
segments the stain)




Neutrophil Lobes (2-4) are Light pinkish-purple or Remains neutral
connected by a pink tan
threadlike filament




Basophil Round, indented, band Dark purple-blue Affinity for methylene
shaped blue
(basic component of
Usually difficult to see the stain)
because of overlying
granules




Nuclear segmentation is another
classification of WBCs. Polymorphonuclear
(PMN) cells – neutrophils, eosinophils, and
basophils – have a multilobed or segmented
nucleus. On the other hand, mononuclear cells
– monocytes (see Figure 1) and lymphocytes
(see Figure 2) have a single mass of nucleus.

Lastly, phagocytic cells – neutrophils,
eosinophils, basophils, monocytes – engulf and
destroy foreign invaders, while lymphocytes,
which are immunologic cells, primarily function
in antibody production.