An AI-powered self-driving microscope for low-cost acute leukemia detection

Abstract Current artificial intelligence systems for leukemia detection typically rely on costly whole-slide scanners, limiting accessibility in low-resource settings. We present ALLocate, a low-cost, artificial intelligence-powered microscope plugin that enables self-driving microscopy for leukemia detection. ALLocate attaches directly to conventional microscopes and provides automated analysis at a fraction of the cost of a whole-slide scanner. We evaluate its robustness at three levels: region-of-interest identification, cell detection, and end-to-end slide-level diagnosis. The system is trained and evaluated using more than 11,000 annotated regions and 130,000 annotated cells and is further validated using independent multi-institutional cohorts, including 165 physical bone marrow smear slides. ALLocate achieves an area under the receiver operating characteristic curve greater than 0.99 for region-of-interest identification, a mean average precision at 50% intersection over union of 0.90 for cell detection, and 88% accuracy for slide-level diagnosis on glass slides without requiring a whole-slide scanner. These results suggest that ALLocate provides an accurate, generalizable, and cost-effective approach for automated bone marrow smear screening, helping bridge the gap between AI innovation and practical deployment in resource-limited settings where access to specialist expertise may be limited.