Swin Transformer and Momentum Contrast (MoCo) in Leukemia Diagnostics: A New Paradigm in AI-Driven Blood Cell Cancer Classification

Acute Lymphoblastic Leukemia (ALL) is a fast-growing blood cancer that requires prompt diagnosis for effective treatment. Automated image diagnostics offer potential solutions but often lack clinical robustness. Despite their widespread use in medical imaging, Convolutional Neural Networks (CNNs) struggle to differentiate morphologically similar ALL subtypes due to limited context and feature discrimination. Moreover, integrating contrastive self-supervised learning with hierarchical attention-based models remains underexplored in hematologic malignancy classification. This study aims to develop a robust, automated classification model for ALL subtypes using peripheral blood smear images, employing advanced feature extraction through the Swin Transformer framework, combined with Momentum Contrast (MoCo) for contrastive learning and a Bidirectional Encoder Transformer for classification. The Swin Transformer’s patch-based embedding and multi-level attention enhance feature discrimination across ALL subtypes, while MoCo generates distinct embeddings, minimizing overlap between cell types. BiET is employed to classify the refined feature vectors, leveraging self-attention mechanisms to improve classification accuracy. The model achieved an overall classification accuracy of 92.5%, with the precision of 90.3%, a recall of 91.1%, and an F1-score of 90.7% across four classes (Benign, Malignant Early Pre-B, Malignant Pre-B, and Malignant Pro-B). Class-specific performance metrics indicate that Malignant Pre-B achieved the highest F1-score of 92.4%. The MoCo framework reduced contrastive loss from 0.5 to 0.097 for benign cells, enhancing feature discrimination. An ablation study revealed that omitting the dynamic queue decreased accuracy by 5%, underscoring its importance for effective feature learning. This approach can be extended to other hematologic malignancies, with potential for further improvement using larger datasets and real-time diagnostic workflows to support precision medicine.