Objective: To study the cytomorphological features of acute leukemia patients and relating them to their immunophenotypic features. Results: Out of 50 cases of acute leukemia, 32(64%) cases were diagnosed as AML, 18 (36%) cases as ALL. Clinical features like fever, generalised weakness, bleeding tendencies, pain abdomen and loss of appetite were observed. On clinical examination pallor, bony tenderness, organomegaly and lymphadenopathy were seen. In peripheral blood examination: anemia, leucocytosis, and thrombocytopenia were observed. Cyto-morphologically, 48.2% ALL and 51.8% AML cases were diagnosed, classified according to FAB as ALL L1 (72.2%) and ALL L2 (27.8%). In AML cases, AML M2 (77.5%) was followed by AML M4 (12.4%). B-lymphoid lineage CD markers included CD19, CD79a and CD34 in (100%) followed by CD10 (86.4%), CD79a (63.6%), HLA-DR (85.61%), Tdt and CD10 (76.9%), CD20 in (46.5%) of cases. In T-ALL all 5 (100%) cases expressed cyCD3 and CD5. In AML cases markers were CD13 in (93.7%) followed by CD34 (81.2%), MPO and CD33 (78.1%) each, CD117 in (71.8%), HLA-DR in (75.8%). CD 64 was a sensitive monocytoid marker being positive in 100% of cases of AML-M4. Two of 50 cases of acute leukemia got lineage correction on FCA. 1(2%) case of ALL L2 and 1(2%) case of AML M2 diagnosed on morphology were reassigned lineage to AML M2 and T-ALL respectively. Conclusion: The study concluded a concordance between cytomorphology and immunophenotyping. However a detailed evaluation from peripheral blood film to cytochemistry and morphology on bone marrow and immunophenotyping is necessary for diagnosing acute leukemia.
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