Causes for Rejection Clotted specimen, quantity not sufficient, blood not fresh, does not meet labeling requirements
Reference Range Most white cells of peripheral blood as well as platelets are acid phosphatase positive. Most white cells of blood have the acid phosphatase reaction inhibited by L(+) tartrate. Results interpreted by pathologist.
Use Diagnose hairy-cell leukemia (leukemic reticuloendotheliosis)
Limitations Tartrate-resistant acid phosphatase is not entirely specific for the diagnosis of hairy-cell leukemia. A few other pathological cells also exhibit tartrate resistance.
Methodology Naphthol AS-BI, fast garnet GBC with and without L(+) tartaric acid
Additional Information There are six isoenzymes of leukocyte acid phosphatase. Of the six, isoenzyme five is not inhibited by L(+) tartrate acid. It has been found that the malignant mononuclear cells of leukemic reticuloendotheliosis ("hairy cell leukemia") contain isoenzyme five and are resistant to inhibition by L(+) tartaric acid. There is evidence the reaction is not entirely specific as tartrate resistant acid phosphatase reactions have been reported in cases of prolymphocytic leukemia and malignant lymphoma as well as some cases of infectious mononucleosis. There have also been reports of rare false-negative results (patients with leukemic reticuloendotheliosis having negative tartrate resistant acid phosphatase reactions).
