How is leukemia diagnosed?

The tests and procedures required to diagnose leukemia are numerous and take considerable time. The point of running so many tests is to establish exactly which type of the disease is present and how far it has progressed.

During the physical examination the doctor looks for signs that point to leukemia, such as the pallor caused by anaemia, enlarged lymph nodes, and an enlarged spleen or liver.

A full blood count, metabolic and biochemical values, liver function tests and the patient's clotting values are all useful in diagnosing leukemia. Alongside these, a peripheral blood smear and examination of a bone marrow sample carry significant diagnostic value.

A bone marrow aspiration biopsy is a necessary and important test for diagnosing acute leukemia. In chronic leukemias an assessment of peripheral blood is usually considered sufficient, and further biopsy procedures may not be needed. In CML the BCR-ABL gene can be identified using genetic testing methods.

The bone marrow test is usually performed on the patient's hip bone. A sample taken from the bone with a long needle is sent to the laboratory, where it is assessed for the presence of cancer cells.