Diagnostic accuracy of cytochemistry in diagnosing acute leukemia

INTRODUCTION Acute leukemia arise when the hematopoietic stem-cells have malignant transformation into undifferentiated cells. Objective To evaluate the diagnostic accuracy of Cytochemistry using Sudan black B(SBB) and Periodic Acid Schiff stains(PAS), for acute leukemia diagnosis in a resource constrained lab. Methods 80 patient were enrolled in this cross sectional study. Detailed history and physical examination with complete blood cells count and numerous hematological indices were obtained by using semi- automated analyzer; SYSMEX KX-21. Slides were made by using peripheral blood / bone marrow smears, fixed by methanol and stained for different cytochemical stains. Leukemia cell analysis was done by using the conventional immunofluorescence method by using the monoclonal antibodies Results The mean age of patients included in the study was calculated to be 39.40±14.76 years, and male to female ratio was 1.3:1. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of cytochemistry using SBB stain for diagnosis of acute leukemia was 91.94%, 100%, 100%, 78.26% & 93.75% respectively taking Flowcytometry as gold standard. Similarly the sensitivity , specificity , PPV., NPV and diagnostic accuracy of cytochemistry using PAS stain for diagnosis of acute leukemia was 100%, 91.94%, 78.26%, 100% & 93.75% respectively taking flowcytometry as gold standard Conclusion According to this study, the cytochemistry using both SBB and PAF stains showed good accuracy for acute leukemia. Therefore, it may substitute Flowcytometry in many cases, in restricted resource set ups.