Introduction

LeukoGnost PERLS kit is used for detection of free ferric ions (Fe3+) (not bound to hemoglobin) in cells, especially in normoblasts (sideroblasts), macrophages (hemosiderin) and other cells containing free iron. The method is based on Prussian/Berlin blue reaction, and it is used for staining blood smears and bone marrow smears, as well as bone marrow histology sections. In those reactions free ferric ions in cells react with potassium hexacyanoferrate in hydrochloric solution, creating blue non-soluble sediment (salt complex). In order to achieve the best possible visual differentiation of ferric deposits in cytoplasm, Nuclear Fast Red reagent is used as counterstain – it stains the nuclei red.
LeukoGnost PERLS kit is used for diagnosing myelodysplastic syndrome that includes refractory anemia and chronic myelomonocytic leukemia. In case of anemias, 15% of red blood cells in bone marrow comprise of sideroblasts that contain at least 5 hemosiderin granules that get stained with Berlin blue. Ferric granules can be distributed in cytoplasm diffusely or perinuclearly (ring-shaped sideroblasts).