Diagnosis of Acute Lymphoblastic Leukemia

The diagnosis of acute lymphoblastic leukemia (ALL) is dependent on the identification and characterization of blast cells in peripheral blood or bone marrow. Although it is not clear why blasts have a tendency to circulate in some patients and not in others, ALL can be reliably diagnosed using peripheral blood or bone marrow blasts when blasts are in circulation [79]. However, distinguishing blasts from activated lymphocytes is difficult in some patients, particularly children. Standard care and thorough evaluation of patients with ALL thus require good bone marrow aspiration, with high-quality smears and bone marrow biopsy specimens. When bone marrow biopsy specimens are available, touch imprints should be made [1].