Leukemia Tests

Diagnosing Leukemia

An accurate diagnosis is crucial to optimal treatment planning and outcomes. This is especially important for leukemia because this disease has numerous subtypes and factors that can determine specific courses of treatment.

At City of Hope, our team of experts can precisely diagnose leukemia, classify its subtype, identify its severity and find the best treatments to fight the disease.

How Is Leukemia Detected?

Once you notice symptoms, or as part of a routine examination, your doctor may use the following tests to look for leukemia:

  • Physical exam
  • Blood tests
    • Complete blood count: This test checks for the number of red blood cells, white blood cells and platelets in your blood sample.
    • Peripheral blood smear: Also known as a blood film, this test smears a thin layer of blood on a glass slide for examination under a microscope.
  • Bone marrow aspiration and biopsy: A hollow needle is inserted into your hipbone or breastbone to extract a sample of bone marrow, blood and bone tissue. A pathologist then examines the tissue for signs of cancer.
  • Imaging tests: Although medical imaging procedures – such as X-ray and magnetic resonance imaging scans – are not typically used to diagnose leukemia, they may be ordered if your doctor suspects that leukemia cells are growing in an organ, such as the spleen or liver.

If cancer is found, additional tests are performed to determine the type and stage of disease. These tests include:

  • Cytogenetic analysis: A test that looks for genetic or chromosomal abnormalities in a blood or bone marrow sample
  • Immunophenotyping: This test looks for specific markers on the surface of the leukemia cells, and is used to help identify the disease subtype.
  • Reverse transcription-polymerase chain reaction (RT-PCR) test: This test uses chemicals to look at structure or function of genes, and can help identify leukemia subtypes.
  • Lumbar puncture (spinal tap): If your doctor suspects that leukemia cells have spread to your brain and spinal cord, a small sample of your cerebrospinal fluid – or CSF – may be extracted from your spine for further evaluation.

What Are the Current Screening Guidelines for Leukemia?

There are currently no screening guidelines for leukemia, since no screenings have been shown to lower risk of dying from leukemia for people of average risk. However, your physician may recommend more vigorous monitoring if you are at a high risk of developing this disease, due to:

  • Personal/family history
  • Specific inherited conditions
  • Prior chemical or radiation exposure
  • Chemotherapy and radiation therapy to treat another cancer