Using literature data on cytogenetic abnormalities in 3,6 I 2 cases of acute myeloid leukemia (AML) and I ,55 I cases of acute lymphocytic leukemia (ALL), we have attempted to quantify the information value of finding the typical ALL-and AMLassociated chromosome aberrations. Sensitivity, specificity, and predictive value of finding or not finding a given aberration were calculated for several diagnostic scenarios: for the differential diagnosis between ALL and AML when the patient is known to have acute leukemia, for the differential diagnosis among AML FAB subtypes in a patient with known AML, and for the differential diagnosis between ALL FAB subtypes in a patient with known ALL. The specificities were generally high, close t o I. The highest sensitivities in AML were found for + 8, t( 15; I7)(q22;q I I), t(8;2 l)(q22;q22). and --7 (all > 0. I), and in ALL for t(9;22)(q34q I I), t(4; I l)(q2 I ;q23), and + 2 I (again all > 0. I). In the AML subtypes, the highest sensitivities were 0.89 for t( 15; I7)(q22;q I I) in M3, followed by 0.40 for t(8;2 l)(q22;q22) in M2, 0.30 for inv( I6)(p I3q22)/del( I6)(q22)/t( 16; I6)(p I3;q22) in M4, and 0. I 6 for t(9; I l)(p2 I ;q23) in M5. In the ALL subtypes, the highest sensitivities were 0.71 and 0. I I for t(8; l4)(q24;q32) and t(822)(q24;q I I), respectively, in L3, 0.23 for t(9;22)(q34;q I I ) in L2. and 0.18 and 0. I 3 for + 2 I and t(4; I l)(q2 l;q23), respectively, in LI. The highest (1.0) positive predictive values in the AML versus ALL comparison were found for t( I ;3)(p36;q21), inv(3)(q2 I q26), t(6;9)(p23;q34). t(7; I I)(p I5;p I 5), t(8; I6)(p I I ;p 13). t(8;2 l)(q22;q22). t( 15; I7)(q22;q I I), and, as sole anomalies, for +4, t 9, and + I I. In the reverse comparison, ALL versus AML, positive predictive values of 1.0 were found for t( I ; 14)(p32-34;q I I), dup( I)(q 12-2 I93 I -32), t(2;8)(p I2;q24), t(8; 14)(q24;q32), t/dic(9; I2)(p I I -l2;p I I -I3), t( 10 14)(q24;q I I), and t( I I ; I4)(p I3;q I I). Among the AML subgroups, the highest predictive values were: I .O for M3 if t( 15; I7), 0.9 I for M2 if t(8;2 I), 0.86 for M4 if inv/del( 16)/t( 16; I6), and 0.82 for M5 if t(9; I I). Among the ALL subtypes, positive predictive values of > 0.8 were reached only for the L3-associated aberrations t(2;8) (I .O), t(8; 14) (0.95), t(8;22) (0.87), and dup( I) (0.80).
The highest negative predictive values were in AML 0.98 that the disease is not M3 if t( 15; 17) is not found, and in ALL 0.96 that the patient does not have L3 if a t(8;14) is not detected. Genes Chrorn Cancer 557-66 (1992). A 1992 Wiiey-Lisr, inc.