What tests are performed to make a diagnosis of ALL?
A number of tests are performed to evaluate a child suspected of having leukemia. The initial test will be a blood test called the complete blood count (CBC). The pediatrician or family doctor may order blood tests before referring the child to a specialist. Those tests are often repeated by the oncologist.
Although leukemia cells may be found in the blood, most commonly, the diagnosis and classification of leukemia are confirmed by looking at a sample of bone marrow under the microscope. This sample is obtained by performing a bone marrow aspirate.
An additional test that may be performed along with the bone marrow aspirate is the bone marrow biopsy.
A spinal tap is usually performed to look for leukemia in the central nervous system.
How is the extent of disease determined?
Since ALL is a cancer of the blood, it is not "staged" in the same way as solid tumors, where physicians look for disease outside the original location. By nature, leukemia is widespread at diagnosis, but this does not affect successful treatment.
In addition to being present in the bone marrow and blood, leukemia can spread to areas that are part of the blood system, causing enlargement of the organs. It can affect:
-
Lymph nodes
-
Liver
-
Spleen
-
Testes
-
Central nervous system
-William Carroll, MD, New York University Medical Center
Reviewed and edited by the
CureSearch.org Medical Editorial Board
September 2006