Acute leukemia is diagnosed by evaluation of the bone marrow. The presence of more than 20% blasts is diagnostic. Flow cytometry is helpful to further define the abnormal population of immature cells. Cytogenetic evaluation should always be performed, as it has important prognostic significance (40). CLL may be diagnosed by the finding of a monoclonal lymphocytosis in the peripheral blood. The typical cell is a mature lymphocyte seen with smudge cells on the peripheral blood smear. Variable numbers of prolymphocytes are often present. Flow cytometry demonstrates predominantly B-cells, expressing CD19 and CD20, with aberrant expression of the T-cell marker, CD5.
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