Garg, Sudershan K., and Silber, Robert: Decreased leukocyte alkaline phosphatase in monocytic leukemia. Am. J. Clin. Pathol. 58: 668–674, 1972. In a review of the diagnosis associated with the finding of a decreased leukocyte alkaline phosphatase value, two previously unreported observations were made. (1) Four of seven patients with monocytic leukemia showed a marked diminution in leukocyte alkaline phosphatase activity. The findings indicate that the leukocyte alkaline phosphatase activity in monocytic or myelomonocytic leukemia may be diminished to levels comparable to those seen in chronic myelocytic leukemia; the alteration in enzyme level was not associated with a chromosomal abnormality in this type of leukemia. It was noted in the preleukemic phase of the disease in two patients. (2) A moderate to marked diminution in leukocyte alkaline phosphatase activity was found in eight patients with hemolytic anemia of varied etiologies.
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