# Retrieval-Augmented Vision Foundation Models for Robust Leukemia Cell Classification across Multiple Microscopy Datasets

arXiv: https://arxiv.org/abs/2608.10657 · HTML: https://mlsanity.com/paper/2608.10657/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 46 references that are in the map.
- First posted on arXiv 11 Aug 2026.

## Builds on (most cited first, 12 of 12)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Parameter-Efficient Fine-Tuning for Large Models: A Comprehensive Survey](https://mlsanity.com/paper/2403.14608/) (2024)
- [Retrieval Augmented Classification for Long-Tail Visual Recognition](https://mlsanity.com/paper/2202.11233/) (2022)
- [Low-Rank Few-Shot Adaptation of Vision-Language Models](https://mlsanity.com/paper/2405.18541/) (2024)
- [DinoBloom: A Foundation Model for Generalizable Cell Embeddings in Hematology](https://mlsanity.com/paper/2404.05022/) (2024)
- [Imbalanced Domain Generalization for Robust Single Cell Classification in Hematological Cytomorphology](https://mlsanity.com/paper/2303.07771/) (2023)
- [Domain-incremental White Blood Cell Classification with Privacy-aware Continual Learning](https://mlsanity.com/paper/2503.19819/) (2025)
- [A Hierarchical Ensemble Inference Pipeline for Robust White Blood Cell Classification Under Domain Shifts](https://mlsanity.com/paper/2604.23271/) (2026)

## Abstract (arXiv)

Leukemia cell image classification is challenged by real-world domain shifts from acquisition, staining, illumination, and site protocols, causing single-dataset models to generalize poorly in real clinical scenarios. This work presents a robust framework for leukemia classification across multiple heterogeneous datasets using a two-stage pipeline with a pretrained vision foundation model. Stage 1 performs binary classification (leukemia vs. non-leukemia) and is trained using 122,167 single-cell images. Stage 2 is conditionally applied to Stage 1 positives to perform subtype classification into Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML), trained using 69,400 single-cell images. Labels are harmonized across five heterogeneous datasets to enable cross-dataset training, and performance is evaluated on a held-out dataset protocol to assess domain-shift generalization. Within this pipeline, three encoders are benchmarked (DinoBloom, pretrained on single-cell images; BiomedCLIP, pretrained on biomedical data; and CLIP as a general-purpose model) under linear probing, Low-Rank Adaptation (LoRA), and a Retrieval-Augmented Classification (RAC) module that retrieves the top-k most similar cell images to provide cytomorphological grounding. The objective is to quantify how much domain-specific pretraining contributes to performance under domain shift, and whether cost-effective adaptation and retrieval can be a viable alternative to expensive domain-specialized pretraining. The held-out protocol additionally serves as a diagnostic tool, revealing when classification performance is attributable to dataset-specific artifacts rather than to cytomorphological features.