Diagnosis of Leukemia
by Debra Wood, RN
Certain symptoms may indicate possible leukemia, such as swollen lymph nodes in the armpits, groin, and neck, as well as unusual bruising, infections, or signs of anemia. Your doctor will ask about your symptoms, and family and medical history. Your abdomen will be thoroughly examined for signs of swelling in the liver or spleen. If there are no other obvious reasons for these symptoms, the doctor may suspect a blood disorder.
Diagnosis of Leukemia
Blood tests may be the first indication of a blood disorder, or it may be done after the physical symptoms above are noted. Blood tests can include:
Bone Marrow Aspiration and Biopsy
The findings from the blood tests can suggest leukemia, but a bone marrow test is usually done to confirm the diagnosis.
A bone marrow aspiration removes a sample of bone marrow from the bone. In most cases, the sample is taken from the hipbone. A needle is inserted through the bone and the marrow is removed with a syringe. A piece of bone may also be removed for biopsy.
Both marrow and bone sample will be examined under a microscope to look for the presence of abnormal blood cells (cancer).
If leukemia is confirmed, results from completed tests and new tests will help determine details about the leukemia that will be used to guide your treatment plan and make a prognosis. Treatment and outcomes also depend on other factors, such as age and overall health.
Tests that may help determine leukemia characteristics:
Acute leukemias are aggressive from the very beginning. They involve bone marrow sites throughout the body and cancer cells have often spread to other organs. Doctors classify these leukemias by type and subtype in an attempt to determine the prognosis and a recommended level of treatment.
Chronic leukemias have a longer, less aggressive course. Over time, they may develop more aggressive characteristics as the cells making up the leukemia become more immature. As a result, chronic leukemias are classified by the type and phase in which the disease is at the time.
In the United States, CML uses a Rai classification to describe the phases of the illness:
Acute lymphoblastic leukemia/lymphoma (ALL) management. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated October 17, 2018. Accessed December 21, 2018.
Acute myeloid leukemia (AML). EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated August 14, 2018. December 21, 2018.
Chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL). EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated November 21, 2017. Accessed December 21, 2018.
Chronic myeloid leukemia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated January 4, 2018. Accessed December 21, 2018.
Davis AS, Viera AJ, Mead MD. Leukemia: an overview for primary care. Am Fam Physician. 2014;89(9):731-738.
Overview of leukemia. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/overview-of-leukemia. Updated December 2018. Accessed December 21, 2018.
Stages of adult acute lymphoblastic leukemia. National Cancer Institute website. Available at: https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq#section/_123. Updated October 19, 2018. Accessed December 21, 2018.
Stages of adult acute myeloid leukemia. National Cancer Institute website. Available at: https://www.cancer.gov/types/leukemia/patient/adult-aml-treatment-pdq#section/_164. Updated October 19, 2018. Accessed December 21, 2018.
Last reviewed October 2017 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 2/2/2016
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