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Tests and diagnosis
By Mayo Clinic staff
Blood tests
Tests and procedures used to diagnose chronic lymphocytic leukemia include blood tests designed to:
- Count the number of cells in a blood sample. A complete blood count may be used to count the number of lymphocytes in a blood sample. A high number of B cells, one type of lymphocyte, may indicate chronic lymphocytic leukemia.
- Determine the type of lymphocytes involved. A test called flow cytometry or immunophenotyping helps determine whether an increased number of lymphocytes is due to chronic lymphocytic leukemia, a different blood disorder or your body's reaction to another process, such as infection. If chronic lymphocytic leukemia is present, flow cytometry may also help analyze the leukemia cells for characteristics that help predict how aggressive the cells are.
- Analyze lymphocytes for genetic abnormalities. A test called fluorescence in situ hybridization (FISH) examines the chromosomes inside the abnormal lymphocytes to look for abnormalities. Doctors sometimes use this information to determine your prognosis and help choose a treatment.
Other tests
In some cases your doctor may order additional tests and procedures to aid in diagnosis, such as:
- Bone marrow biopsy and aspiration
- Computerized tomography (CT)
Staging
Once a diagnosis is confirmed, your doctor determines the extent (stage) of your chronic lymphocytic leukemia. Two different staging systems are used. Each assigns a stage — early, intermediate or advanced — that indicates the progression of a person's chronic lymphocytic leukemia. These levels are used to determine your treatment options.
- Montserrat E, et al. Chronic lymphocytic leukaemia: A short overview. Annals of Oncology. 2008;19(suppl):vii320.
- Caligaris-Cappio F, et al. Novel insights in chronic lymphocytic leukemia: Are we getting closer to understanding the pathogenesis of the disease? Journal of Clinical Oncology. 2008;26:4497.
- Elphee EE. Caring for patients with chronic lymphocytic leukemia. Clinical Journal of Oncology Nursing. 2008;12:417.
- Dighiero G, et al. Chronic lymphocytic leukaemia. The Lancet. 2008;371(9617):1017.
- Nabhan C, et al. Controversies in the front-line management of chronic lymphocytic leukemia. Leukemia Research. 2008;32:679.
- Chronic lymphocytic leukemia treatment (PDQ) patient version. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/CLL/patient/allpage/print. Accessed Oct. 13, 2008.
- Hallek M, et al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: A report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute Working Group 1996 guidelines. Blood. 2008;111:5446.
- SEER stat fact sheets. Surveillance Epidemiology and End Results. http://seer.cancer.gov/statfacts/html/clyl.html. Accessed Oct. 15, 2008.
- Questions about treatment. The Leukemia & Lymphoma Society. http://www.leukemia-lymphoma.org/graphics/National/Allquestionsworksheets/QuestionsabouttreatmentPS172R.pdf. Accessed Oct. 15, 2008.
- Campath (prescribing information). Cambridge, Mass.: Genzyme Corp.; 2007. http://www.fda.gov/cder/foi/label/2007/103948s5070lbl.pdf. Accessed Oct. 15, 2008.
- Rituxan (prescribing information). San Francisco, Calif.: Genentech; 2008. http://www.fda.gov/cder/foi/label/2008/103705s5256lbl.pdf. Accessed Oct. 15, 2008.
- Cancer-related fatigue. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/fatigue.pdf. Accessed Oct. 15, 2008.
- Shanafelt TD (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 12, 2008.
