Blood Cancer Diagnosis and Staging

May 10, 2024 
This page was reviewed under our medical and editorial policy by Leslie Popplewell, M.D., Hematologist and Medical Director of Hematology and Blood and Bone Marrow Transplant, City of Hope Atlanta

Several tests are available to assist with diagnosis for patients who may have blood cancer. For patients who have already been diagnosed, staging systems allow health care providers to measure and monitor the cancer’s progress.

This guide may help patients and their families learn more about blood cancer diagnosis and staging.

Tests to Diagnose Blood Cancer

Every patient is unique, and each blood cancer makes different changes in the body. The type of blood cancer suspected determines which type of diagnostic test will be requested.

The most commonly used tests to diagnose blood cancer include those listed below.

Blood tests: This may include a complete blood count (CBC), blood chemistry testing and others.

Bone marrow testing: A biopsy of the bone marrow may help the care team pinpoint the patient’s diagnosis and stage.

Imaging tests: These may include magnetic resonance imaging (MRI), X-ray and computed tomography (CT) scans to get a better picture of what’s going on in the patient’s bones and soft tissues.

Lumbar puncture: The care team may order this test to detect whether blood cancer cells are present in the patient’s cerebrospinal fluid.

Each patient’s health care provider will provide more details about what to expect during testing and when results will be ready.

Blood Cancer Stages

Blood cancer staging follows different criteria than other types of cancer because blood cancers don’t typically form into solid tumors.

While each type of blood cancer uses a slightly different staging system, what follows is an example of how leukemia is staged using the Rai staging system. Blood markers and patient symptoms are the foundations of each stage.

Stage 0: The patient may have an increased white blood cell count, but no other symptoms.

Stage 1: The patient may have an increased white blood cell count and enlarged lymph nodes.

Stage 2: The patient may have an increased white blood cell count and an enlarged liver and/or spleen. Lymph nodes may be swollen.

Stage 3: The patient may have an increased white blood cell count and also anemia. Enlarged lymph nodes and an enlarged spleen or liver may also be present.

Stage 4: The patient may have an increased white blood cell count and also low levels of platelets. Swollen lymph nodes and an enlarged spleen or liver are also possible. In stage 4 patients, anemia may also be present.

Read more to learn about blood cancer stages by type:

If patients have questions about what their stage means for their blood cancer treatment plan, their cancer care team is available to assist with information and blood cancer support.

References
References
  • Cancer Research UK (2023, April 3). Getting diagnosed with acute myeloid leukaemia (AML) Tests. 
    https://www.cancerresearchuk.org/about-cancer/acute-myeloid-leukaemia-aml/getting-diagnosed/tests

  • American Society of Clinical Oncology (2017, October). Leukemia - Chronic Lymphocytic - CLL: Stages. 
    https://www.cancer.net/cancer-types/leukemia-chronic-lymphocytic-cll/stages