Leukemia

Results from routine blood work can alert your healthcare provider that you may have an acute or chronic form of leukemia that requires further testing. Or they may recommend a workup if you have leukemia symptoms.

Diagnostic exams and tests may include:

• Physical exam: Your healthcare provider will ask about your symptoms and feel for swollen lymph nodes and an enlarged spleen or liver. They may also inspect your gums for bleeding and swelling. They may look for a skin rash associated with leukemia that may appear red, purple or brown.
• Complete blood count (CBC): This blood test lets your healthcare provider know if you have abnormal levels of red blood cells, white blood cells and platelets. If you have leukemia, you’ll likely have higher than normal counts of white blood cells.
• Blood cell examination: Your healthcare provider may take additional blood samples to check for markers that indicate the presence of leukemia cells or a specific type of leukemia. Flow cytometry and peripheral blood smear are additional tests your healthcare provider may order.
• Bone marrow biopsy (bone marrow aspiration): Your healthcare provider may perform a biopsy if you have an abnormal white blood cell count. A long needle inserted into your bone marrow (usually in your pelvic bone) draws out fluid during the procedure. The fluid sample gets tested in a lab for leukemia cells. A bone marrow biopsy helps determine the percentage of abnormal cells in your bone marrow, confirming a leukemia diagnosis.
• Imaging and other tests: Your doctor may order a chest X-ray, CT scan, or magnetic resonance imaging (MRI) scan if symptoms indicate leukemia has affected your bones, organs or tissue. The leukemia cells don’t show up on imaging.
• Lumbar puncture (spinal tap): Your healthcare provider may test a sample of spinal fluid to see if leukemia has spread to the spinal fluid surrounding your brain and spinal cord.