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π§ͺ Leukocyte Alkaline Phosphatase (LAP) is an enzyme found in neutrophils. The LAP score (0β400) is used as a diagnostic aid in distinguishing between **reactive vs malignant myeloproliferative processes**.
π§ͺ Leukocyte Alkaline Phosphatase (LAP) is a useful tool in differentiating between a Leukemoid Reaction (benign/reactive) and Chronic Myeloid Leukaemia (CML).
Feature | Leukemoid Reaction ①(Reactive) | CML 𧬠(Malignant) |
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Cause | Infection, stress, haemorrhage | BCR-ABL fusion gene (Philadelphia chromosome) |
WCC | Raised, usually < 50 Γ 10βΉ/L | Very high, often > 100 Γ 10βΉ/L |
Cells | β Neutrophils with toxic granulation | All myeloid stages: myeloblasts β mature neutrophils |
LAP score | π High (reactive neutrophils) | π Low (clonal defect in CML) |
Spleen | Usually normal | Splenomegaly common |
Genetics | None | Philadelphia chromosome t(9;22) present |