Recommended procedures for the classification of acute leukaemias. International Council for Standardization in Haematology (ICSH). 1993

C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
Haematological Malignancy Diagnostic Service, Leeds General Infirmary, England, UK.

The classification of acute leukaemias is now widely based on a combined morphological, cytochemical and immunophenotyping approach. Difficulties are frequently encountered however in reaching an acceptable degree of diagnostic concordance between different laboratories because of variations in the techniques used (in terms of methodologies, reagents and equipment) and diagnostic interpretation. The International Council for Standardization in Haematology (ICSH) convened an expert panel to consider currently available diagnostic techniques with the aim of defining a minimum cytochemical and immunological diagnostic panel that could be used as core components for the classification of acute leukemia. The proposed ICSH scheme, which attempts to balance the basic requirement for providing precise and informative diagnostic information without limiting its use to only those laboratories with sophisticated facilities, is based on three sequential levels of investigation; primary cytochemistry, intracellular phenotyping and membrane immunophenotyping. The minimum ICSH recommended cytochemistries comprise myeloperoxidase (MPO), chloroacetate esterase (ChlorE) and alpha-naphthyl acetate esterase (ANAE), and standardised methods for these cytochemistries are detailed in this communication. For cases of acute leukaemia that remain unclassified by primary cytochemistry, subsequent immunological analyses for cytoplasmic CD3, CD22, MPO and nuclear TdT are recommended. The ICSH panel considers that the use of these minimum primary cytochemical and intracellular phenotyping procedures will lead to the consistent classification of most acute leukaemias, and that the third level of investigation (membrane immunophenotyping) should be used for the purposes of confirmation, diagnostic clarification of atypical leukaemias, and the subtyping of acute lymphoblastic leukaemias (ALL). The ICSH panel also recognised that there are a number of additional technologies which can provide definitive diagnostic information, such as cytogenetics and DNA genotyping, but these were excluded from the minimum panel because of their restricted availability. While many specialised laboratories, particularly in the areas of diagnostic research, will continue to use individual investigatory protocols, it is considered that the inclusion of the ICSH scheme as core components would lead to greater consistency when comparing independent studies of acute leukemia.

UI MeSH Term Description Entries
D007938 Leukemia A progressive, malignant disease of the blood-forming organs, characterized by distorted proliferation and development of leukocytes and their precursors in the blood and bone marrow. Leukemias were originally termed acute or chronic based on life expectancy but now are classified according to cellular maturity. Acute leukemias consist of predominately immature cells; chronic leukemias are composed of more mature cells. (From The Merck Manual, 2006) Leucocythaemia,Leucocythemia,Leucocythaemias,Leucocythemias,Leukemias
D009195 Peroxidase A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. Myeloperoxidase,Hemi-Myeloperoxidase,Hemi Myeloperoxidase
D009283 Naphthol AS D Esterase Hydrolytic enzyme activity used as a histocytochemical test for the presence of esterases in tissue. Substrate used is 3-hydroxy-4'-nitro-2-naphthanilide chloroacetate (naphthol AS-D). ANAE,Naphthol AS D Acetatesterase,Naphthol AS D Chloroacetate Esterase,alpha-Naphthyl Acetate Esterase,alpha Naphthylesterase,alpha-Naphthylacetate Esterase,Acetate Esterase, alpha-Naphthyl,Esterase, alpha-Naphthyl Acetate,Esterase, alpha-Naphthylacetate,Naphthylesterase, alpha,alpha Naphthyl Acetate Esterase,alpha Naphthylacetate Esterase
D002265 Carboxylic Ester Hydrolases Enzymes which catalyze the hydrolysis of carboxylic acid esters with the formation of an alcohol and a carboxylic acid anion. Carboxylesterases,Ester Hydrolases, Carboxylic,Hydrolases, Carboxylic Ester
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D016130 Immunophenotyping Process of classifying cells of the immune system based on structural and functional differences. The process is commonly used to analyze and sort T-lymphocytes into subsets based on CD antigens by the technique of flow cytometry. Lymphocyte Immunophenotyping,Lymphocyte Subtyping,Immunologic Subtyping,Immunologic Subtypings,Lymphocyte Phenotyping,Subtyping, Immunologic,Subtypings, Immunologic,Immunophenotyping, Lymphocyte,Immunophenotypings,Immunophenotypings, Lymphocyte,Lymphocyte Immunophenotypings,Lymphocyte Phenotypings,Lymphocyte Subtypings,Phenotyping, Lymphocyte,Phenotypings, Lymphocyte,Subtyping, Lymphocyte,Subtypings, Lymphocyte

Related Publications

C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
January 1985, Clinical and laboratory haematology,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
August 2002, International journal of hematology,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
December 2020, International journal of laboratory hematology,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
October 2016, International journal of laboratory hematology,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
March 2018, Thrombosis and haemostasis,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
December 2021, International journal of laboratory hematology,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
January 2003, Laboratory hematology : official publication of the International Society for Laboratory Hematology,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
April 2008, International journal of laboratory hematology,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
August 2025, International journal of laboratory hematology,
C S Scott, and G J Den Ottolander, and D Swirsky, and G A Pangalis, and J L Vives Corrons, and A de Pasquale, and L van Hove, and J M Bennett, and K Namba, and G Flandrin
January 1981, Clinical and laboratory haematology,
Copied contents to your clipboard!