Debra Wood, RN
Certain symptoms may indicate possible leukemia, such as swollen lymph nodes in the armpits, groin, and neck, as well as unusual bruising, infections, or signs of anemia. Your doctor will ask about your symptoms, and family and medical history. Your abdomen will be thoroughly examined for signs of swelling in the liver or spleen. If there are no other obvious reasons for these symptoms, the doctor may suspect a blood disorder.
Blood tests may be the first indication of a blood disorder, or it may be done after the physical symptoms above are noted. Blood tests can include:
The findings from the blood tests can suggest leukemia, but a bone marrow test is usually done to confirm the diagnosis.
A bone marrow aspiration removes a sample of bone marrow from the bone. In most cases, the sample is taken from the hipbone. A needle is inserted through the bone and the marrow is removed with a syringe. A piece of bone may also be removed for biopsy.
Both marrow and bone sample will be examined under a microscope to look for the presence of abnormal blood cells (cancer).
If leukemia is confirmed, results from completed tests and new tests will help determine details about the leukemia that will be used to guide your treatment plan and make a prognosis. Treatment and outcomes also depend on other factors, such as age and overall health.
Tests that may help determine leukemia characteristics:
Acute leukemias are aggressive from the very beginning. They involve bone marrow sites throughout the body and cancer cells have often spread to other organs. Doctors classify these leukemias by type and subtype in an attempt to determine the prognosis and a recommended level of treatment.
Chronic leukemias have a longer, less aggressive course. Over time, they may develop more aggressive characteristics as the cells making up the leukemia become more immature. As a result, chronic leukemias are classified by the type and phase in which the disease is at the time.
In the United States, CML uses a Rai classification to describe the phases of the illness:
Acute leukemia overview. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/acute-leukemia-overview. Updated October 2014. Accessed February 2, 2016.
Acute lymphoblastic leukemia/lymphoma (ALL). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116388/Acute-lymphoblastic-leukemia-lymphoma-ALL. Updated August 26, 2016. Accessed October 6, 2016.
Acute myeloid leukemia (AML). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114798/Acute-myeloid-leukemia-AML. Updated July 6, 2016. Accessed October 6, 2016.
Chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114637/Chronic-lymphocytic-leukemia-CLL-Small-lymphocytic-leukemia-SLL. Updated March 7, 2016. Accessed October 6, 2016.
Chronic myeloid leukemia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115889/Chronic-myeloid-leukemia-CML. Updated March 19, 2015. Accessed October 6, 2016.
Davis AS, Viera AJ, Mead MD. Leukemia: an overview for primary care. Am Fam Physician. 2014;89(9):731-738.
Stages of adult acute lymphoblastic leukemia. National Cancer Institute website. Available at: http://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq#section/_123. Updated September 17, 2015. Accessed February 2, 2016.
Stages of adult acute myeloid leukemia. National Cancer Institute website. Available at: http://www.cancer.gov/types/leukemia/patient/adult-aml-treatment-pdq#section/_164. Updated September 17, 2015. Accessed February 2, 2016.
Last reviewed December 2015 by Mohei Abouzied, MD
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