Leukocyte Alkaline Phosphatase Levels in Myeloproliferative Disorders? - USMLE Forums
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Old 05-21-2012
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Blood Leukocyte Alkaline Phosphatase Levels in Myeloproliferative Disorders?

Guys,
Both CML and Polycythemia Vera are myeloproliferative disorders. right ?
they have quite similar presentation...splenomegaly with hypercellular marrow. but in CML LAP score is low but in PV LAP score is high.
Do you know the reason? plz share...
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Old 05-21-2012
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Immature forms vs mature leukocytes
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Old 05-22-2012
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LAP is a score that is given to the activity of the enzyme in the WBC,
Usually CML may look like acute infection in a blood smear so we do this test to confirm it's not acute infection. CML gets a overall low score because the altough some neutrophils are mature most of them are not mature and they dont have high activity of the enzyme. in Acute infection neutrophils are mature and will have high score.
PV have nothing to do with the maturity of the neutrophils, and the score will be high as normally it is when the neutrophils are mature.
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Old 05-22-2012
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LAP is connected with the benign Granulocytes and not preset in the malignant ones. As CML is the disorder with malignant Basophils, it falls down whereas in others, it goes up. tis is what i had understood from Goljan explanation in that section
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