Leukocyte Alkaline Phosphatase Stain (LAP)
Optimizing Laboratory Testing for Hematologic
In conclusion, LAP is a test that time has clearly passed by. It is a test that may result in nonspecific and potentially misleading information and, thus, we strongly believe that the LAP provides no clinical value for patient care. Therefore, the LAP test will be discontinued September 2010. If other testing is needed to diagnose or exclude CML or other MPN, then BCR/ABL or JAK2 assays should be considered.
Thank you for the opportunity to present to you and hopefully I have been able to introduce you to the concept of how the laboratory can help control utilization of ancillary testing in hematologic diseases. Although the LAP assay will not be a significant assay in any test utilization strategy, the approach we used does show how a laboratory can use data analysis to help convince clinicians on the lack of clinical value for a potentially obsolete test. Our second goal today was more practical as we wanted to share why we will no longer be offering LAP testing through Mayo Medical Laboratories. I look forward in future Hot Topics to continue our discussion of the laboratory’s and pathologist’s roles in appropriate laboratory test utilization in hematologic disorders.
Jump to section:
- Optimizing Laboratory Testing for Hematologic Disorders Series
- The Big Picture: We Need to Focus On...
- LAP: A Test That Time Has Passed By
- LAP: Assay History
- LAP: Original Clinical Utility
- LAP Procedure—an Inexact Science!
- Typical Staining Type Reaction
- Subjective Nature of the Scoring Process
- LAP Scoring Example
- LAP Discontinued at Mayo Clinic
- Low LAP Scores* Not Specific for CML: A Mayo 1-Year Experience
- Low LAP Scores* Do Not Indicate Myeloid Malignancy: A Mayo 1-Year Experience
- High LAP Scores* Not Specific for PV: A Mayo 1-Year Experience
- High LAP Scores* Do Not Indicate Myeloid Malignancy: A Mayo 1-Year Experience
- LAP: A Test Whose Time Has Passed
- Consequences of an Abnormal LAP
- Alternatives to LAP
- Alternatives to LAP: BCR/ABL
- Alternatives to LAP: JAK2