Leukemia diagnosis and staging
UCHealth specialists use a series of leading-edge tests on your blood and bone marrow to properly diagnose leukemia. We may also take samples of other tissue and cells to help guide your treatment.
- Blood tests. We perform a complete blood count and blood cell exam (peripheral blood smear). We may also perform other tests.
- Flow cytometry. A machine that looks for certain markers on or in cells that help identify what types of cells they are. This test is important in diagnosing chronic lymphocytic leukemia (CLL).
- Bone marrow aspiration and biopsy. Usually taken from the back of the pelvic bone, but sometimes we may take them from other bones.
- Cytogenetics. We grow bone marrow cells or other cells in a lab, and examine the chromosomes.
- Fluorescent in situ hybridization (FISH). Used to look at chromosomes and DNA without having to grow the cells in the lab.
- cDNA sequencing. Looks at the genes in immunoglobulins, the antibodies that help your body fight infections. Especially important in staging CLL.
- Lymph node biopsy. Usually done for lymphomas, and may be done for types of leukemia.
- Lumbar puncture or spinal tap. Done if your doctor suspects leukemia cells may have spread to the area around the brain or spinal cord, or if there might be an infection in those areas.
- CT scan. Shows if any lymph nodes or organs in your body are enlarged.
- PET/CT scan. Uses a radioactive atom injected into the blood to show cancer cells.
- Magnetic resonance imaging (MRI) scan. Most useful in looking at the brain and spinal cord.
- Ultrasound. Looks at lymph nodes and enlarged organs inside your abdomen.
Staging is the process of determining the extent of a cancer based on the size of the main tumor and how far it has spread. Leukemia has a slightly different staging process as the different types don’t form tumors. Each type does have a standard system for staging, which your doctor can share with you and explain what it means, and how it affects your personalized treatment plan.