Flowcytometry is the most powerful technology for immunophenotyping of acute leukemia. In developing countries with limited resource laboratories, sustainability of advanced technology such as flowcytometry is always an issue, especially with lack of technical support and backup equipments. Most of the times when machine get out of order the reagents are available but got expired after awhile. In attempt to put a solution for these situations, we evaluate the role of fluorescence microscopy (FM) in determination of acute leukemia lineage in emergency situation.
Methodology
Fifty cases with initial diagnosis of acute leukemia, Sudan Black B negative and blast count more than 50% were included. Wet preparation examined under binocular fluorescent microscope using 2 filters and the following antibodies: CD34, CD19, CD79a, CD10, cCD3, CD5, CD117, CD13, and CD33 &CD42.
Result
FM technique managed to determine the lineage in 68% of the cases. The best result obtained in cases of B-ALL as 89.3% of suspected cases were confirmed. Six out of nine cases suspected to be T-ALL were proved. Most of the inconclusive results (76.9%) were obtained with suspected cases of AML (M0, M5&M7).
Conclusion: Poor resource laboratories can use fluorescence microscopy as backup in acute leukemia lineage determination.