Diagnostic Criteria for Hematological Malignancies

Introduction to Diagnostic Markers

The American Society of Hematology recommends using immunophenotypic markers, such as CD34, CD117, and HLA-DR, to establish lineage assignment and distinguish acute leukemias from lymphomas 1, 2
The National Comprehensive Cancer Network suggests that these markers are essential for diagnosing hematological malignancies through flow cytometry 6

The World Health Organization recommends using CD34, CD117, and HLA-DR to identify immature myeloid blasts and establish AML diagnosis 1, 2, 3
The American Society of Hematology suggests that CD13 and CD33 are essential myeloid markers retained throughout granulocytic maturation 1, 2, 3
The European LeukemiaNet recommends using CD11b and CD15 to provide additional information for granulocytic differentiation 1, 2

The National Comprehensive Cancer Network suggests using CD19, CD10, cytoplasmic CD79a, and cytoplasmic CD22 to establish B-lineage 1, 2, 6
The American Society of Hematology recommends using CD3 to definitively establish T-lineage 1, 2, 6
The International Society for Laboratory Hematology suggests using CD20 to distinguish mature B-cell ALL from other subtypes 6

The World Health Organization recommends using stringent criteria for lineage assignment, including MPO expression or at least 2 monocytic markers (CD11c, CD14, CD64, lysozyme) for myeloid lineage 1, 2, 4
The European LeukemiaNet suggests using strong CD19 with at least 1 of cytoplasmic CD79a, cytoplasmic CD22, or CD10 for B-lineage 1, 2

The American Society of Hematology recommends using CD45 with side scatter to identify blast gate and establish pan-leukocyte marker essential for gating 5, 1, 7
The National Comprehensive Cancer Network suggests checking cMPO first to establish myeloid lineage, and then assessing CD19 and cytoplasmic CD3 for lymphoid lineage 1, 2, 9

The International Society for Laboratory Hematology recommends defining strong expression as equal to or brighter than normal B or T cells in the sample 1, 2, 3
The American Society of Hematology suggests counting at least 200 leukocytes on blood smears and 500 nucleated cells on marrow smears for accurate blast enumeration 1, 2, 9
The European LeukemiaNet recommends using multiparameter flow cytometry with minimum 3-4 colors for adequate immunophenotyping 11, 10