Leukaemia, acute lymphoblastic
The first step in diagnosing acute lymphoblastic leukaemia is to check for physical signs of the condition, such as swollen glands, and to take a blood sample.
If the blood sample contains a high number of abnormal white blood cells, it could be a sign of acute leukaemia. Your GP will refer you to a haematologist (a specialist in treating blood conditions).
To confirm a diagnosis of acute leukaemia, the haematologist will take a small sample of your bone marrow to examine under a microscope.
The haematologist will use a Local anaesthetic to numb the skin over a bone usually the hip bone before removing a sample of bone marrow with a needle. You may experience some pain once the anaesthetic wears off and some bruising and discomfort for a few days afterwards. The procedure takes around 15 minutes and you shouldn't have to stay in hospital overnight.
The bone marrow will be checked for cancerous cells and, if found, the type of acute leukaemia will be determined at the same time.
Some people with acute leukaemia will need to have a bone marrow assessment to check for cancerous cells every three months for at least two years during maintenance treatment or after having a bone marrow transplant .
A number of additional tests (described below) can be used to find out about the progress and extent of the leukaemia. They can also help guide treatment.
Cytogenetic testing involves identifying the genetic make-up of the cancerous cells. Specific genetic variations can occur during leukaemia, and knowing what these variations are can have an important impact on treatment.
Immunophenotyping is a test to help identify the exact type of acute lymphoblastic leukaemia. A sample of blood, bone marrow or another type of fluid is studied.
This testing is important as the treatment needed may be slightly different for each type.
A polymerase chain reaction (PCR) test can be carried out on a blood sample. PCR can help diagnose and monitor the response to treatment.
The blood test is repeated every three months for at least two years after starting treatment, then less often once remission is achieved.
If you've been diagnosed with acute leukaemia, further biopsies may be carried out on any enlarged lymph nodes that you have. These will establish how far the leukaemia has spread.
If you have acute leukaemia, a computerised tomography (CT) scan may be used to assess how far the leukaemia has spread and to check that your organs, such as your heart and lungs, are healthy.
You may have an X-ray so that the chest can be examined for any swollen lymph nodes.
A lumbar puncture may be carried out if there's a risk that acute leukaemia has spread to your nervous system.
A needle is inserted into the lower part of your spine to extract a small sample of cerebrospinal fluid (the fluid that surrounds and protects your spine), which istested for cancer cells.
Acute leukaemia is a type of cancer which affects certain cells present in the blood white blood cells, red blood cells and thrombocytes. All of the cells present in the blood are produced by the blood marrow or bones, which is found inside the bone.
A common test for this condition is a blood workup of peripheral blood, which can lead doctors to believe this diagnosis is possible. Following this, a blood marrow biopsy may be necessary. This test involves extracting material from the inside of the bone, and subsequently analyzing it.
Treatment is usually carried out in three stages known as induction, consolidation and maintenance. The patient must become hospitalized. The patient then receives blood transfusions, and extra care is taken against infections. Following this, chemotherapy may be applicable (using cytostatic preparations), which aims to eliminate the sick cells.
Being immunocompromised (having a weakened immune system) is a possible complication for some patients with acute leukaemia. Patients suffering from acute leukaemia face a high risk of infection. This may be due to the patient's immune system becoming compromised, or due to the suppression of the immune system by the medication usually administered to treat leukaemia.
When Hazel Phillips went to see her GP about an ear infection, she suspected something more serious was wrong because of her other symptoms. A blood test confirmed her worst fears: she had acute lymphoblastic leukaemia.