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The Better View on Acute Lymphoblastic Leukemia Including Peripheral Blood and Bone Marrow Cells as Well as Hematopoietic Microenvironment

Ahmad Reza Rahnemoon

Adult Hematopoietic Stem Cells (HSCs) are undifferentiated cells capable of self-renewal and remain component in the process of hematopoiesis which together with the cells that makeup the bone marrow stromal environment and other factors. However, when this process of cell production is unbalanced; leading to an exacerbated and uncontrolled proliferation of blood progenitor cells, so leukemia may develop. We know, the basis of acute leukemia classification remains morphology and cytochemistry. The examination of both peripheral blood and bone marrow films are necessary for the diagnosis and classification of ALL. After the slides study, we can say that leukemia is the consequence of stepwise some alterations that confer both proliferative and survival advantage, as well as self-renewal capacity to the malignant cells including precursor cells, blast cells and other differentiated immature cells as well.  In ALL, lymphoid precursor cells are arrested in the early stages of development by the abnormal expression of genes. As a result, RT-PCR or FISH analysis is required to detect this rearrangement.

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