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Diagnosis
Other Tests
Doctors sometimes find leukemia after a routine
blood test. If you have symptoms that suggest
leukemia, your doctor will try to find out what's
causing the problems. Your doctor may ask about your
personal and family medical history.
You may have one or more of the following tests:
- Physical exam: Your doctor checks for swollen
lymph nodes, spleen, or liver.
- Blood tests: The lab does a complete blood count to
check the number of white blood cells, red blood
cells, and platelets. Leukemia causes a very high
level of white blood cells. It may also cause low
levels of platelets and hemoglobin, which is found
inside red blood cells.
- Biopsy: Your doctor removes tissue to look for
cancer cells. A biopsy is the only sure way to know
whether leukemia cells are in your bone marrow.
Before the sample is taken, local anesthesia is used
to numb the area. This helps reduce the pain. Your
doctor removes some bone marrow from your
hipbone or another large bone. A pathologist uses a
microscope to check the tissue for leukemia cells.
There are two ways your doctor can obtain bone
marrow. Some people will have both procedures
during the same visit:
- Bone marrow aspiration: The doctor uses a
thick, hollow needle to remove samples of bone
marrow.
- Bone marrow biopsy: The doctor uses a very
thick, hollow needle to remove a small piece of
bone and bone marrow.
The tests that your doctor orders for you depend on
your symptoms and type of leukemia. You may have
other tests:
- Cytogenetics: The lab looks at the chromosomes of
cells from samples of blood, bone marrow, or lymph
nodes. If abnormal chromosomes are found, the test
can show what type of leukemia you have. For
example, people with CML have an abnormal
chromosome called the Philadelphia chromosome.
- Spinal tap: Your doctor may remove 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
lower spine. The procedure takes about 30 minutes
and is performed with local anesthesia. You 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: An x-ray can show swollen lymph
nodes or other signs of disease in your chest.
You may want to ask your doctor these
questions before having a bone marrow aspiration
or biopsy:
- Will you remove the sample of bone marrow
from the hip or from another bone?
- Where will I go for this procedure?
- Will I have to do anything to prepare for it?
- How long will it take? Will I be awake?
- Will it hurt? What will you do to prevent or
control the pain?
- Are there any risks? What are the chances of
infection or bleeding after the procedure?
- How long will it take me to recover?
- How soon will I know the results? Who will
explain them to me?
- If I do have leukemia, who will talk to me
about next steps? When?
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