Diagnosis ofleukemiainvolves a number of steps.
It often begins with a complete blood count (CBC) and peripheral blood smear.
A bone marrow aspiration and biopsy are also done with most types of leukemia.
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There are many different variations of leukemia and an accurate diagnosis is important for choosing the besttreatmentoptions.
Your doctor will ask you aboutsymptoms of leukemiaandrisk factors forthe disease that you may have.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
It can also identify whether your RBCs are large or small.
A peripheral smear can provide more details about the bang out of WBCs in the blood.
After a sample of the bone marrow is aspirated, a biopsy sample is also taken.
Tests can include both flow cytometry and immunohistochemistry.
ALL cells that have more DNA than an average cell tend to respond better to chemotherapy.
Each of our cells normally has 46 chromosomes that contain many genes.
Some studies look primarily at chromosomal changes, whereas others look for changes in specific genes.
Cytogenetics
Cytogenetics involves microscopic examination of the chromosomes of cancer cells.
Chromosomal changes that may be seen in the leukemia cells include:
Cytogenetics can help with planning treatment.
For example, in ALL, leukemia cells that have more than 50 chromosomes respond better to treatment.
The Philadelphia chromosome is also an important finding in some people who have ALL.
With CLL, cytogenetics is less helpful, and FISH and PCR are more important for finding genetic changes.
Fluid is then withdrawn and sent to a pathologist to be analyzed.
It may be helpful, however, in staging some leukemias, such as CLL.
An X-ray may show enlargement of lymph nodes orosteopenia(thinning of the bone).
It may be helpful in leukemias that involve the brain or spinal cord.
Differential Diagnosis
There are some diseases that may resemble leukemia.
Some of these include:
Staging
Once leukemia has been confirmed, it must be staged.
Staging refers to the system used by doctors to categorize a cancer.
Staging differs between thedifferent types of leukemia.
This usually involves cytogenetic tests, flow cytometry, and other lab tests.
A CBC paired with a peripheral blood smear and another diagnostic test calledflow cytometrymay provide definitive evidence of leukemia.
This is why a bone marrow biopsy may be needed.
FISH can detect chromosome changes specific to different types of leukemia.
Death rates are highest among people 75 and over.
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