Overview
Test menu reference, institutional panels vary; verify local algorithms.
Classification
| Test | Specimen | Role in workup | MLS note |
|---|---|---|---|
| Peripheral smear | EDTA blood | Screening morphology, blast quantification | Reflex per flags/protocol |
| Bone marrow aspirate | Marrow | Blasts, dysplasia, flow, genetics | Handle per SOP, viable cells for cytogenetics |
| Trephine biopsy | Marrow core | Cellularity, fibrosis, focal lesions | Complements aspirate |
| Flow cytometry | Blood or marrow | Lineage, clonality, immunophenotype | Viability and timing critical |
| Karyotype | Marrow (viable) | Chromosome survey | Culture failure possible |
| FISH | Marrow or blood | Targeted abnormalities (BCR-ABL1, del(17p) among probes) | Rapid turnaround for some targets |
| Molecular PCR/NGS | Marrow or blood | Fusions (BCR-ABL1) and mutations (FLT3, NPM1 among panels) | Panel content institutional |
| SPEP / immunofixation | Serum | Monoclonal protein detection | Rouleaux screening clue on smear |
| Serum free light chains | Serum | Light chain myeloma, FLC ratio | With SPEP in plasma cell workup |
Morphologic Features
Laboratory Characteristics
- Reflex algorithms institution-specific
Reference Intervals
Clinical and Laboratory Significance
Integrated hematopathology report combines morphology, flow, and genetics.
Differential Considerations
Comparison Tables
Classification Frameworks
Laboratory Notes
- Integrate laboratory findings with clinical context; verify local reference intervals and reflex rules.
References
Authoritative textbooks, guidelines, and reviews supporting this reference entry. Verify reference intervals, critical limits, and reflex criteria against institutional protocols and current guideline editions.
Textbooks
- Arber DA, Orazi A, Hasserjian RP, et al. Atlas of Diagnostic Hematology. 4th ed. Elsevier; 2023.
- Bain BJ. Blood Cells: A Practical Guide. 6th ed. Wiley-Blackwell; 2022.
- Rodak BF, Carr JH. Rodak's Hematology: Clinical Principles and Applications. 6th ed. Elsevier; 2020.
- McKenzie SB, Williams JL. Clinical Laboratory Hematology. 4th ed. Pearson; 2022.
- Hoffbrand AV, Moss PAH, Pettit JE. Essential Haematology. 8th ed. Wiley-Blackwell; 2019.
CLSI and Professional Guidelines
- International Consensus Classification of Myeloid Neoplasms and Acute Leukemias (ICC). Blood. 2022;140(11):1200–1228.
WHO Publications
- World Health Organization. WHO Classification of Haematolymphoid Tumours. 5th ed. Volume 11. Lyon: IARC Press; 2024.
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