Review Article

Annals of Hematology

, Volume 86, Issue 5, pp 311-327

First online:

Diagnostic pathways in acute leukemias: a proposal for a multimodal approach

  • Torsten HaferlachAffiliated withMLL Munich Leukemia Laboratory Email author 
  • , Ulrike BacherAffiliated withBone Marrow Transplantation, University Hospital Hamburg Eppendorf
  • , Wolfgang KernAffiliated withMLL Munich Leukemia Laboratory
  • , Susanne SchnittgerAffiliated withMLL Munich Leukemia Laboratory
  • , Claudia HaferlachAffiliated withMLL Munich Leukemia Laboratory

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access


Acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) each represent a heterogeneous complex of disorders, which result from diverse mechanisms of leukemogenesis. Modern therapeutic concepts are based on individual risk stratification at diagnosis and during follow-up. For some leukemia subtypes such as AML M3/M3v with t(15;17)/PMLRARA or Philadelphia-positive ALL targeted therapy options are available. Thus, optimal therapeutic conditions are based on exact classification of the acute leukemia subtype at diagnosis and are guided by exact and sensitive quantification of minimal residual disease during complete hematologic remission. Today, a multimodal diagnostic approach combining cytomorphology, multiparameter flow cytometry, chromosome banding analysis, accompanied by diverse fluorescence in situ hybridization techniques, and molecular analyses is needed to meet these requirements. As the diagnostic process becomes more demanding with respect to experience of personnel, time, and costs due to the expansion of methods, algorithms, which guide the diagnostic procedure from basic to more specific methods and which lead finally to a synopsis of the respective results, are essential for modern diagnostics and therapeutic concepts.


Acute leukemias Diagnosis Cytogenetics PCR Multiparameter flow cytometry