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Diagnosis of Leukemia

Different types of leukemia are diagnosed in different ways.

Diagnosis of Acute Lymphocytic Leukemia 

Doctors diagnose acute lymphocytic leukemia based on a physical exam; complete blood count, including a white blood cell count; platelet count; bone marrow aspiration and biopsy; and lumbar puncture to check for leukemia cells in the spinal fluid.

Diagnosis of Acute myeloid leukemia 

With acute myeloid leukemia, there may be signs of a swollen spleen, liver or lymph nodes. A complete blood count will show anemia and a low number of platelets. The white blood cell count can be high, low or normal. Bone marrow aspiration will show if leukemia cells are present.

If your doctor learns you do have this type of leukemia, further tests will be done to determine the specific type of AML. There are eight subtypes of the disease, ranging from M0 to M7, based on which blood cells are abnormal.

Diagnosis of Chronic Lymphocytic Leukemia (CLL) 

Patients with chronic lymphocytic leukemia (CLL) usually have a higher-than-normal white blood cell count and may have signs of a swollen spleen, liver or lymph nodes.

Doctors diagnose and assess CLL with a complete blood count with white blood cell differential; bone marrow biopsy; CT scan of the chest, abdomen and pelvis; immunoglobulin testing; and lactate dehydrogenase test. If your doctor discovers you have CLL, tests will be done to stage the cancer.

Diagnosis of Chronic Myelogenous Leukemia 

A physical examination of patients with chronic myelogenous leukemia often reveals a swollen spleen.

Tests include a complete blood count, bone marrow biopsy, blood and bone marrow testing for the presence of the Philadelphia chromosome, and platelet count.

Diagnosis of Hairy Cell Leukemia 

During a physical exam, doctors may be able to feel a swollen spleen or liver in patients with hairy cell leukemia. An abdominal CT scan may be done to evaluate the swelling.

A complete blood count usually shows low levels of white and red blood cells as well as platelets. Blood tests and a bone marrow biopsy can detect hairy cells. Flow cytometry or a test called tartrate resistant acid phosphatase (TRAP) can confirm the diagnosis.

What is Leukemia? 

Leukemia is a type of blood cancer that begins in the bone marrow, the soft tissue in the center of bones that produces blood cells. The term "leukemia" literally means "white blood."

White blood cells (leukocytes) made in the bone marrow are used by the body to fight off infections and other foreign substances. Leukemia leads to an uncontrolled increase in the number of white blood cells.

The cancerous cells prevent healthy red cells, platelets and mature white cells from being produced, causing life-threatening symptoms as they spread to the bloodstream and lymph nodes. They can also travel to the central nervous system (brain and spinal cord) and other parts of the body.

Types of Leukemia 

Leukemias are either acute and progress quickly or chronic and progress more slowly.

Acute Lymphocytic Leukemia 

Acute lymphocytic leukemia (ALL) is a fast-growing cancer of white blood cells called lymphocytes found in the bone marrow and other parts of the body. ALL occurs when the body produces a large number of immature lymphocytes that grow quickly and replace normal cells in the bone marrow.

Acute Myeloid Leukemia 

Acute myeloid leukemia (AML) starts inside bone marrow and grows quickly, replacing healthy blood cells. One of the most common types of leukemia among adults, AML generally occurs around age 60 and is more common in men than women.

Chronic Lymphocytic Leukemia 

Chronic lymphocytic leukemia (CLL) causes a slow increase in white blood cells called B lymphocytes, or B cells. The cancerous cells spread from the bone marrow to the blood, and can also affect the lymph nodes or other organs such as the liver and spleen. CLL eventually causes the bone marrow to fail.

Chronic Myelogenous Leukemia

Chronic myelogenous leukemia occurs most often in middle-aged adults and in children. It is usually associated with a chromosome abnormality called the Philadelphia chromosome.

Hairy Cell Leukemia 

Hairy cell leukemia (HCL) is an unusual cancer of the blood that affects B cells, a type of white blood cell, or lymphocyte. HCL is caused by the abnormal growth of B cells. The cells look "hairy" under the microscope because they have fine projections coming from their surface.