Leukemia is a type of cancer that originates in the blood-forming tissues, including the bone marrow and lymphatic system. This condition involves the uncontrolled production of abnormal white blood cells, which can interfere with the body’s ability to produce healthy blood cells. An accurate and timely diagnosis is fundamental for effective management and can significantly influence the course of the disease.
When Testing Becomes Necessary
Testing for leukemia is considered when individuals experience persistent, unexplained symptoms. These indicators can include ongoing fatigue, recurrent fevers without an obvious cause, or frequent infections that are difficult to resolve. Other common signs that may prompt a doctor to investigate further involve easy bruising or bleeding, which can manifest as nosebleeds or gum bleeding.
Physical examination might reveal swollen lymph nodes, an enlarged spleen, or an enlarged liver. While these symptoms are not exclusive to leukemia and can point to various other conditions, their presence warrants a medical evaluation. A physical assessment helps determine if further diagnostic steps are needed.
Initial Blood Tests
Initial leukemia diagnosis involves specific blood tests. A Complete Blood Count (CBC) is a common starting point, measuring the number of red blood cells, white blood cells, and platelets. Abnormalities such as unusually high or low white blood cell counts, or the presence of immature or abnormal red blood cells, can raise suspicion for leukemia. Similarly, a low platelet count, which affects blood clotting, might also be an indicator.
Following the CBC, a Peripheral Blood Smear is often performed. A small blood drop is examined under a microscope. This examination allows laboratory specialists to visually inspect the size, shape, and maturity of blood cells. The presence of blast cells, which are immature white blood cells not typically found in circulating blood, is a significant finding that suggests the possibility of leukemia and necessitates further investigation. These initial blood tests serve as screening tools, identifying potential issues that require more definitive diagnostic procedures.
Bone Marrow Examination
A bone marrow examination is a crucial procedure for confirming a leukemia diagnosis. This process involves two main parts: a bone marrow aspiration and a bone marrow biopsy. During the aspiration, a small amount of liquid bone marrow is extracted using a needle. The biopsy involves removing a small solid piece of bone marrow tissue.
These samples are then sent to a laboratory for detailed analysis. The primary purpose of this examination is to directly assess the cells within the bone marrow, which is the site of blood cell production. Pathologists examine the samples to identify the presence of cancerous cells, known as blasts, and to determine the percentage of these abnormal cells within the marrow. This direct visualization and quantification of blast cells are essential for confirming a leukemia diagnosis and understanding the extent of the disease.
Specialized Diagnostic Tools
Specialized tests provide further classification of leukemia, which is important for guiding treatment. Flow cytometry is a technique that analyzes cells based on their surface markers, allowing for the identification of specific types of leukemia cells. This method helps categorize the exact subtype of leukemia by detecting distinct proteins on the cell surface.
Cytogenetics and Fluorescence In Situ Hybridization (FISH) are genetic tests used to identify chromosomal abnormalities within leukemia cells. Cytogenetics involves examining the chromosomes under a microscope for structural changes, while FISH uses fluorescent probes to highlight specific genetic sequences. These tests can reveal characteristic translocations or deletions associated with certain leukemia types. Molecular testing further refines the diagnosis by detecting specific gene mutations. These mutations influence leukemia behavior and therapy response, aiding prognosis and management.