Chronic myelogenous leukemia

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Tests and diagnosis

By Mayo Clinic staff

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Illustration showing a needle suctioning out liquid bone marrow from the hipbone 
Bone marrow biopsy

Test and procedures used to diagnose chronic myelogenous leukemia include:

  • Physical exam. Your doctor will examine you and check such vital signs as pulse and blood pressure. He will also feel your lymph nodes, spleen and abdomen for abnormalities.
  • Blood tests. A complete blood count (CBC) may reveal abnormalities in your blood cells. Blood chemistry tests to measure organ function may also reveal abnormalities that can help your doctor make a diagnosis.
  • Bone marrow tests. Bone marrow biopsy and bone marrow aspiration are used to collect bone marrow samples for laboratory testing. These tests involve collecting bone marrow from your hipbone.
  • Tests to look for the Philadelphia chromosome. Specialized tests, such as fluorescence in situ hybridization (FISH) analysis and polymerase chain reaction (PCR) test, analyze blood or bone marrow samples for the presence of the Philadelphia chromosome or the BCR-ABL gene.

Phases of chronic myelogenous leukemia
The phase of chronic myelogenous leukemia refers to the aggressiveness of the disease. Your doctor determines the phase by measuring the proportion of diseased cells to healthy cells in your blood or bone marrow. A higher proportion of diseased cells means chronic myelogenous leukemia is at a more advanced stage.

Phases of chronic myelogenous leukemia include:

  • Chronic. The chronic phase is the earliest phase and generally has the best response to treatment.
  • Accelerated. The accelerated phase is a transitional phase when the disease becomes more aggressive.
  • Blastic. Blastic phase is a severe, aggressive phase that becomes life-threatening.
References
  1. Chronic myelogenous leukemia. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/cml.pdf. Accessed Sept. 11, 2008.
  2. Chronic myelogenous leukemia treatment (PDQ) patient version. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/CML/patient/allpages/patient. Accessed Sept. 11, 2008.
  3. Chronic myelogenous leukemia and related disorders: An overview. In: Lichtman MA, et al. Williams Hematology. 7th ed. New York, N.Y.: McGraw-Hill; 2006. http://www.accessmedicine.com/content.aspx?aID=2148618. Accessed Sept. 11, 2008.
  4. Leukemia - chronic myeloid - CML. Cancer.Net. http://www.cancer.net/patient/Cancer+Types/Leukemia+-+Chronic+Myeloid+-+CML. Accessed Sept. 17, 2008.
  5. Integrative medicine and complementary and alternative therapies as part of blood cancer care. The Leukemia & Lymphoma Society. http://www.leukemia-lymphoma.org/attachments/National/br_1150734030.pdf. Accessed Sept. 17, 2008.
  6. Questions about treatment. The Leukemia & Lymphoma Society. http://www.leukemia-lymphoma.org/graphics/National/Allquestionsworksheets/QuestionsabouttreatmentPS172R.pdf. Accessed Sept. 16, 2008.
  7. Kantarjian H, et al. Chronic myeloid leukemia. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008:2279-2291.
  8. SEER stat fact sheets - chronic myeloid leukemia. Surveillance Epidemiology and End Results. http://seer.cancer.gov/statfacts/html/cmyl.html. Accessed Sept. 19, 2008.
  9. Tasignia (prescribing information). East Hanover, N.J.: Novartis; 2007.
  10. Gleevec (prescribing information). East Hanover, N.J.: Novartis; 2007.
  11. Sprycel (prescribing information). Princeton, N.J.: Bristol-Myers Squibb; 2007.

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Nov. 13, 2008

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