Leukemia Stains

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Definition

Leukemia stains are laboratory tests done on bone marrow or blood samples to help diagnose specific types of leukemia.

Description

Special stains are added to bone marrow or blood that has been smeared on a microscope slide. Cell types react differently to the chemicals in the stains.

If the patient has few white cells, a buffy coat smear is made. A tube of blood is spun in a centrifuge. Red cells fall, plasma rises, and white cells settle in a thin middle layer called the buffy coat. The smear is made from this layer.

This stain distinguishes between acute lymphoblastic leukemia (cells stain positive) and acute myeloblastic leukemia (cells stain negative).

The PAS stain is primarily used to identify erythroleukemia, a leukemia of immature red blood cells. These cells stain a bright fuchsia.

The TdT stain differentiates between acute lymphoblastic leukemia (cells stain positive) and acute myelogenous leukemia (cells stain negative).

The LAP stain is used to determine if an increase of cells is due to chronic myelogenous leukemia or a noncancerous

reaction to an infection or similar conditions. Cells from a noncancerous reaction stain positive with many intense blue granules; cells from chronic myelogenous leukemia have few blue granules.

The TRAP stain is primarily used to identify hairy cell leukemia cells. These cells stain with purple to dark red granules.

The myeloperoxidase stain distinguishes between the immature cells in acute myeloblastic leukemia (cells stain positive) and those in acute lymphoblastic leukemia (cells stain negative).

This stain identifies granulocytes, which show red granules.

Nonspecific esterase stain identifies monocytes and immature platelets (megakaryocytes), which show positive black granules.

— Nancy J. Nordenson