Hematological monitoring of acute lymphoblastic leukemia by automated flow cytochemistry (Bayer Technicon H*1)

Background and Methods. The usefulness of hematological parameters provided by the Technicon H*1 was investigated for the diagnosis of acute lymphoblastic leukemias (ALL) and for the identification of blast cells in peripheral blood samples. Results and conclusions. When automated blast detection was compared with microscopic examination in 62 samples with 4-98% morphologically recognizable lymphoblasts on peripheral blood smears, a false-negative result occurred in 28% (17/62) of the ALL cases. However, in 14 of these 17 false-negative cases the H*1 generated an output listing that would require microscopic evalution in any event. The H*1 output listing interpretaion (based on abnormal leukograms, blast flags and bicytopenia) led us to suspect the presence of ALL in 76% (47/62) of the cases. Three ANLL were recognized as ALL. In three out the 62 ALL, the H*1 output listing interpretation missed identify a leukemic process. In most cases (77%) we noted a characteristic deformation of the mononuclear population profile in the baso/lobbularity display, and the cloud of analytical points was shifted toward to the left, in keeping with the presence of a large number of hypodense nuclei.