Laboratory diagnosis of acute leukemia in Iraq, the available options.

Diagnosis of acute leukemia in Iraq is mainly dependent on the personal experience of the laboratory physician. Local guidelines in this field were never proposed and the international guidelines are very difficult to apply as the only available techniques include morphology of peripheral blood and bone marrow specimens plus very limited immunohistochemistry CD markers and PCR testing for BCR-ABL oncogene only, therefore the aim for diagnosis, classification and subclassification of acute leukemia in this country should be that of diagnosis and lineage assignment that serves a clear therapeutic goal. Having been working in the field of laboratory hematology since 2003 in the major teaching hospitals in Baghdad, I found that the following scheme is the available useful option: Acute leukemia should be classified on the basis of FAB group, but using a cut-off point of 20% blast cells, as proposed in the WHO classification [1].