Diagnosis
If a person has symptoms that suggest leukemia, the doctor may do a
physical exam and ask about the patient's personal and family medical
history. The doctor also may order laboratory tests, especially blood
tests.
The exams and tests may include the following:
Physical exam—The doctor checks for swelling of the
lymph nodes,
spleen,
and liver.
Blood tests—The lab checks the level of blood
cells. Leukemia causes a very high
level of white blood cells. It also
causes low levels of platelets and hemoglobin,
which is found inside red blood cells. The lab also may check the blood for signs
that leukemia has affected the liver and kidneys.
Biopsy—The
doctor removes some bone marrow from the hipbone or another large
bone. A pathologist
examines the sample under a microscope. The removal of tissue to
look for cancer cells is called a biopsy.
A biopsy is the only sure way to know whether leukemia cells are in
the bone marrow.
There are two ways the doctor can obtain bone marrow. Some patients
will have both procedures:
Local anesthesia helps to make the patient more
comfortable.
Cytogenetics—The lab looks at the chromosomes of
cells from samples of peripheral blood, bone marrow, or lymph nodes.
Spinal tap—The doctor removes some of the cerebrospinal
fluid (the fluid that fills the spaces in and around the brain and
spinal cord). The doctor uses a long,
thin needle to remove fluid from the spinal column. The procedure takes about 30 minutes and is performed with local
anesthesia. The patient must lie flat
for several hours afterward to keep from getting a headache. The lab checks the fluid for leukemia cells
or other signs of problems.
Chest x-ray—The x-ray can reveal signs of disease in the chest.
A person who needs a bone marrow aspiration or bone
marrow biopsy may want to ask the doctor the following questions:
Will you remove the sample of bone marrow from the
hip or from another bone?
How long will the procedure take? Will I be awake? Will it hurt?
How soon will you have the results? Who will explain them to me?
If I do have leukemia, who will talk to me about
treatment? When?
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